Objective To investigate the the treatment of class Ⅲ malocclusion by orthognathic surgery combined with postoperative orthodontics.Methods Nine patients with skeletal class Ⅲ malocclusion were treated by surgery-first approach without pre-surgical orthodontic from January 2012 to August 2014.The studied sample consisted of 7 women and 2 men (aged 15-28 years old, mean age 19.7 years), who had obvious mandibular protrusion.2 to 3 days after surgery, intermaxillary traction was used to made the maxilla and mandible together by board;we replaced a rubber band every 2 to 3 days and lasted for four weeks.We would dismantle board and performed conventional orthodontic treatment after patient's facial swelling subsided, and the positional relationship between the jaw stabilized.Results The face type of 9 patients were greatly improved after orthodontic treatment for 6.5 to 19.5 months.Patients and their family members felt satisfied, and their occlusal function returned to normal.At 3 to 32 months follow-up, the postoperative appearance and occlusion were becoming good without obvious signs of recurrence.Conclusions The surgery-first approach is an effective method to treat skeletal class Ⅲ malocclusion.

Objective To determine association between tongue carcinoma and polymorphism of urokinase-type plasminogen activator (PLAU) gene.Methods PLAU genotypes of 97 patients with tongue carcinoma and 91 health controls were examined by the PCR-RFLP method.Statistical analyses included a chi-square test for homogeneity and logistic regression analysis.Results The polymorphism in PLAU gene was rs2227564 C/T.Logistic analyses indicated that compared with CT and TT genotypes,CC genotype was risk factor for development of tongue carcinoma (adjusted OR =1.281,95 ％ CI 1.098-2.577,P =0.037).Conclusion PLAU polymorphism may be associated with development of tongue carcinoma.

BACKGROUND:n mandibular posterior dental implantation,injury to the inferior alveolar nerve sometimes occurs because of mandibular canal going across mandibular body.This restricts the use of dental implantation at this site.Therefore,it is essential to understand the anatomic structure of inferior alveolar nerve canal in mandibular posterior dental implantation.OBJECTIVE:To observe the intramandibular course of and anatomic structure of inferior alveolar nerve canal.METHODS:Fifteen adult complete mandible specimens with teeth and 4 fresh mandible arterial infusion specimens were researched.All the specimens had complete dentition and there were no obvious absorption in alveolar bone.The course of inferior alveolar nerve canal and its dimension including transverse and longitudinal diameters of mandibular canal and the distance between mandibular canal and mandible each side (superior,inferior,buccal and lingual side) were measured in 15 adult mandibles with teeth.The relationship between blood vessels and nerve of the canal was observed in 4 fresh arterial infusion specimens.RESULTS AND CONCLUSION:The distance between the medial border of the mandibular canal and the lingual wall was shorter than that of the lateral wall of the mandibular canal to the buccal wall (P < 0.01);The length from the upper wall of mandibiular canal to the top of the alveolar ridge was longer than that of the inferior border of the mandibular canal to the inferior border of the mandible (P < 0.01).The longitudinal diameter was smaller than the transverse diameter (P < 0.05),namely,the cross section of the mandibular canal was an ellipse with a longer longitudinal diameter.There was no significant difference between the transverse and longitudinal diameters of the canal in the anterior and posterior teeth region of the mandible.The inferior alveolar nerve and its associated blood vessels were located within a nervous vascular bunch in the mandibular canals.In every fresh specimen the blood vessels lay above the nerve.There were small branches of blood vessels surrounding thenerve.The mandibular canal ran towards the lingual side and was close to the inferior margin of the mandible.

BACKGROUND:Tissue-engineered bone scaffold fabricated by 3D-bioprinting technique has good controlability in morphology and structure. However, construction of tissue-engineered bone/cel growth factor complex and time-dose effect of sustained-release factors are needed to be further researched.
OBJECTIVE:To fabricate a sustained-release composite of polylactic-co-glycolic acid (PLGA)/nano-hydroxyapatite (n-HA) scaffold carrying bone morphogenetic protein-2 (BMP-2) using 3D-bioprinting technique, and test the biological properties of the PLGA/n-HA scaffold carrying BMP-2 and the sustained-release properties, thereby to discuss its feasibility as the tissue-engineered bone scaffold composite.
METHODS:Temperature-sensitive chitosan hydrogel was prepared using chitosan andβ-glycerophosphate to construct a sustained-release composite, chitosan nanoparticles carrying BMP-2 . 3D-bioprinting technique was utilized to fabricate the PLGA/n-HA scaffold carrying BMP-2. Biological features of the scaffold composite were tested, and time-dose effect of BMP-2 sustained-release was observed.
RESULTS AND CONCLUSION:The average pore size of the scaffold-cytokine composite was (431.31±18.40)μm, and the porosity was (73.64±1.82)%. The cumulative release rate of BMP-2 from the scaffold-cytokine composite that effectively controled the burst release during 48 hours and 30 days were suitable for the physiological needs. In conclusion, the porosity, pore size, release property, degradation rate, and mechanical strength of the scaffold-cytokine composite al meet the biological requirements of tissue-engineered bone construction.

Objective To explore the changes of programmed death receptor-1 (PD-1) in chronic hepatitis B (CHB) patients with different baseline of hepatitis B virus (HBV) DNA levels after treatment with adefovir dipivoxil (ADV).Methods One hundred CHB patients with positive hepatitis B e antigen (HBeAg),1 × 104 copy/mL≤HBV DNA≤1 × 107 copy/mL,and positive human leukocyte antigen-A2 were divided into two groups according to the baseline HBV DNA level:47 cases in low virus load group whose HBV DNA level was ≤1 × 105 copy/mL; 53 cases in high virus load group whose HBV DNA level was＞1 × 105 copy/mL.Both groups were treated with ADV 10 mg/d.Serum HBV DNA,HBeAg seroconversion rate,alanine aminotransferase (ALT) and total bilirubin (TBil) levels of both groups before treatment and 12 months after treatment were compared.Flow cytometry was used to test peripheral blood HBV-specific cytotoxic T lymphocyte (CTL) surface PD-1 and peripheral blood HBV-specific CTL level.Categorical data were tested by x2 test; quantitative data was compared with t-test.Results Peripheral blood HBV-specific CTL surface PD-1 of CHB patients in low virus load group was 20.17 ％±1.69％,which was lower than that in high virus load group (41.38％±2.30％,t =53.02,P＜0.01) ; peripheral blood HBV specific CTL levels in two groups were 0.37％±0.02％ and 0.17％± 0.02％,respectively (t=50.47,P＜0.01) ; ALT and TBil levels in low virus load group were both lower than those of high virus load group (t=13.07,P＜0.01; t=5.06,P＜0.01).Twelve months after treatment,HBV DNA of 25 cases (53.2％) in low virus load group and 10 cases (18.9％) in high virus load group were lower than the detectable level (HBV DNA＜500 copy/mL,x2 =12.89,P＜0.01);HBeAg seroconversion was achieved in 15 cases(31.9％) and 1 case (1.9％),respectively (x2 =16.72,P＜0.01) ; peripheral blood HBV-specific CTL surface PD-1 expression levels were 9.00 ％ ±1.38 ％ and 29.40 ％ ± 3.76 ％,respectively (t =36.80,P＜ 0.01) ; peripheral blood HBV-specific CTL levels were 0.65％±0.10％ and0.48％±0.07％,respectively (t=9.61,P＜0.01).Conclusions After treatment with ADV,along with the decrease of HBV DNA load,HBV-specific CTL surface PD-1 expression decreases,while HBV-specific CTL level increases.The changes in low virus load group are much more remarkable.

OBJECTIVETo compare the effects of 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden for treatment of intracranial hypertension in patients with severe traumatic brain injury.

METHODSWe used an alternating treatment protocol to compare the effects of hypertonic saline with that of mannitol given for episodes of increased intracranial pressure (ICP) in patients with severe brain injury. Standard guidelines for the management of severe traumatic brain injury were followed. For episodes of increased ICP, 20% mannitol (2 ml/kg, infused for over 20 min) and 15% saline (0.42 ml/kg, administered as a bolus via a central venous catheter) of similar osmotic burden were given alternately, with the choice of agent for the initial hypertensive event determined on a randomized basis. Reduction of ICP and duration of the action were recorded after each event.

RESULTSThe data were collected from 33 patients with 237 hypertensive events. The mean decrease in ICP was 8.7 mm Hg at 28.7∓9.3 min after mannitol treatment as compared with 9.3 mm Hg at 23.6∓7.1 min after treatment with hypertonic saline (P>0.05). The mean duration of the effect was 270 min for mannitol and 318 min for hypertonic saline (P>0.05).

CONCLUSIONSTreatment with 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden produces similar effects in management of increased ICP in patients with severe traumatic brain injury in terms of the time of action onset, maximum ICP reduction, and duration of action.

Brain Injuries ; therapy ; Humans ; Intracranial Hypertension ; therapy ; Mannitol ; therapeutic use ; Saline Solution, Hypertonic ; therapeutic use

OBJECTIVETo analyze the formant frequency of vowels in the sequence therapy of patient with cleft palate.

METHODSThe formant frequency of vowels [a], [e], [i], [u] of normal children and postoperative patients with and without speech therapy was measured and analyzed by VS-99.

RESULTS1. The mean value of F1, F2, F3 of [a] did not show significant difference among the three groups (P > 0.05). 2. The difference of mean value of [e] was significant between control group and pre-speech-therapy group, and between pre-speech-therapy and post-speech-therapy group (P < 0.05), but no significant difference was found between post-speech-therapy and control group(P > 0.05). The mean value of the formant in post-speech-therapy was higher than that of pre-speech-therapy. 3. The difference of mean value of [i] was significant between pre-speech-therapy and post-speech-therapy (P < 0.05), the mean value of F2, F3 in post-speech-therapy group decreased significantly compared with control (P < 0.05). 4. The difference of mean value of [u] showed significance between pre-speech-therapy and post-speech-therapy (P < 0.05), while the differences among other groups were insignificant (P > 0.05).

CONCLUSIONSurgical repair of cleft palate cannot make all patients obtain perfect Velopharyngeal competence (VPC), while speech therapy can improve patient's pronunciation. Speech spectrum analysis can judge the effect of cleft palate therapy objectively.

Adolescent ; Adult ; Articulation Disorders ; etiology ; physiopathology ; Child ; Cleft Palate ; complications ; physiopathology ; surgery ; Female ; Humans ; Male ; Postoperative Period ; Sound Spectrography ; Speech ; physiology ; Speech Articulation Tests ; Speech Production Measurement ; Speech Therapy ; Velopharyngeal Insufficiency ; etiology ; physiopathology

Objective To explore the nutritional risk influencing factors in stroke patients， and to discuss the formulation of rehabilitation nursing countermeasures. Methods We randomly selected 152 patients with acute hemorrhagic stroke admitted to our hospital from July 2018 to July 2020. Based on the results of the mini nutritional assessment （MNA） score， the patients were divided into normal group （49 cases）， risk group （53 cases）， and bad group （50 cases）. Single factor analysis and correlation analysis were used to analyze the nutritional risk factors， and the countermeasures for the influencing factors were discussed. Results Univariate analysis showed that stroke time， mechanical ventilation， swallowing dysfunction， ADL score， upper arm muscle circumference， serum albumin， and total lymphocyte count in risk and bad groups were different from the normal group. In comparison， the proportion of patients with mechanical ventilation and swallowing dysfunction was higher， and ADL score， upper arm muscle circumference， serum albumin level and total lymphocyte count were lower （P<0.05）. The Spearman rank correlation analysis showed that the factors with differences in the univariate analysis also showed correlation （P<0.05）. Among them， the positive correlation factors included the duration of stroke， receiving mechanical ventilation， swallowing dysfunction， NIHSS score， negatively related factors included ADL score， serum levels of albumin， transferrin， and hemoglobin. Multivariate Logistic regression analysis showed that stroke time （OR=1.739， P<0.001） and swallowing dysfunction （OR=3.966， P=0.008） were independent risk factors for malnutrition. ADL score （OR=0.687， P<0.001）， upper arm muscle circumference （OR=0.770， P=0.012）， serum albumin level （OR=0.870， P=0.003） were independent protective factors for malnutrition. Conclusion The nutritional status in stroke patients is not optimistic. Most patients have swallowing disorders， motor dysfunction， and poor self-care ability. At the same time， the body protein content in patients has decreased significantly. The clinical work is needed to deal with the patients' swallowing function recovery together with the treatment of nerve damage.

Objective To investigate whether endoscopic ultrasonography (EUS) can be an alternative method for diagnostic endoscopic retrograde cholangiopancreatography (ERCP) by comparing the ability of EUS versus CT and transabdominal ultrasonography (TUS) in the diagnosis of muddy stones of the common bile duct. Methods A prospective study was conducted for 53 patients suspected of muddy stones of the common bile duct who attended Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2019 to December 2021, and all patients underwent EUS, TUS, and CT before ERCP. With ERCP and endoscopic sphincterotomy (EST) for removing muddy stones of the common bile duct as the gold standard for the diagnosis of muddy stones of the common bile duct, EUS, TUS, and CT were compared in terms of their ability to display the muddy stones of the common bile duct. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results In the 53 patients, EUS, TUS, and CT had a positive rate of 88.68%, 50.94%, and 62.26%, respectively, in detecting muddy stones of the common bile duct. As for the positive results confirmed by EST under ERCP, EUS had a sensitivity of 93.75%, a specificity of 60.00%, and an accuracy of 90.57% in detecting muddy stones of the common bile duct, while TUS had a sensitivity of 56.25%, a specificity of 100.00%, and an accuracy of 60.38% and CT had a sensitivity of 66.67%, a specificity of 80.00%, and an accuracy of 67.92%. There was a significant difference between EUS and CT in the accuracy in detecting muddy stones of the common bile duct ( χ 2 =8.26, P =0.004), and there was also a significant difference in diagnostic accuracy between EUS and TUS ( χ 2 =13.05, P < 0.001). Conclusion EUS is more accurate than TUS and CT in the diagnosis of muddy stones of the common bile duct, and instead of ERCP, EUS is thus recommended for suspected muddy stones of the common bile duct when TUS and CT fail to identify the lesions in clinical practice, so as to make a confirmed diagnosis and reduce related costs and complications.