Objective:To compare 3 maxillofacial trauma scoring systems in mandible fracture grading.Methods:Maxillofacial Injury Severity Score(MISS),Maxillofacial Injury Severity Score(MFISS),Mandible Injury Severity Score(S5)were used in the analysis of mandible fracture severity in 313 cases with mandible fractures.The results were statistically analyzed.Results:S5 score showed higher correlation with operation time,operation charge and hospitalization expenses than MFISS and MISS,and it could distinguish single and multiple mandible fractures effectively.It was also a significant factor affecting the cost of hospitalization.Conclusion:The Mandible Injury Severity Score was more suitable for the scoring of mandible fracture.

Objective:To review and compare the clinical features and treatment outcomes of oral and maxillofacial space infection (OMSI)between diabetic and non-diabetic patients.Methods:Clinical data of 43 diabetic patients with OMSI(simultaneoustly treated by blood sugar control)and 84 of non-diabetic patients with OMSI were reviewed,the clinical features and treatment outcomes were compared.Statistical analyses were conducted by T test,the chi square test and variance analysis.Results:Diabetic patients with OM-SI were older(P =0.000),had more spaces involved concurrently(P =0.035 )and had higher blood sugar at presentation(P =0.000).There was no significant difference between groups about the use and change of antibiotics,the incision times,hospital stay durition and the incidence of the complications.Conclusion:The prognosis of the diabetic patients with OMSI under the strict control of the blood glucose concentration has no significant difference from the non-diabetic patients with OMSI.Diabetic patients with OMSI have older age and more spaces involved,and special attention should be paid.

Actins ; metabolism ; Bone Neoplasms ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Hypophosphatemia ; blood ; etiology ; Ilium ; Mesenchymoma ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Osteomalacia ; blood ; etiology ; Phosphates ; blood ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Tomography, X-Ray Computed

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Objective To investigate whether the surgery resorting to computer-assisted navigation system (CANS) can enhance effects in managing unilateral old zygomatic complex (ZMC) fracture in comparison with conventional surgery.Methods Twenty-four patients with unilateral old ZMC fracture for which surgical correction was wanted were divided into study group (n =12,treated with navigational surgery) and control group (n =12,treated with traditional surgery) in the 1 ∶ 1 matched case-control study.Therapeutic effects of CANS were evaluated by postoperative CT measurement,subjective satisfaction questionnaire and clinical examination.Results According to postoperative three-dimensional CT measurement,the mean projection and width differentials of bilateral zygomatic bones were 1.58 mm and 1.47 mm in study group,3.58 mm and 3.63 mm in control group,with significant differences between groups.No complications occurred within three months of follow-up.Moreover,the patients in study group were all satisfied with the treatment,but two patients in control group desired further surgery to ameliorate zygomatic shape.Conclusion Surgery with application of CANS improves efficacy of treatment for unilateral old ZMC fracture.

ObjectiveTo investigate the diagnostic value of EUS-FNA for pancreatic masses and correlated influential factors. MethodsWe retrospectively analyzed the clinical data of 101 patients with pancreatic lesions who underwent EUS-FNA from January 2008 to January 2010. The clinical data enrolled 10 factors including patient gender, patient age, lesion location, lesion size, lesion characteristics, negative suction pressure, times of access, real-time cytological diagnosis, type of EUS and operators' experiences.ResultsThe overall diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EUS-FNA were 85. 1％, 81.1％, 96. 3％, 98. 4％ and 65.0％, respectively. Univariable logistic regression analysis indicated that lesion size, lesion characteristics, negative suction pressure, operators' experience were correlated factors of EUS-FNA positive rate, while lesion size was the only correlated factor of EUS-FNA diagnostic accuracy ( OR =1. 984,95 ％ CI: 1. 141 ～ 3. 451, P =0. 015 ). Every 1 cm the lesion increased, by 1.67 times of opportunity the positive rate became, by 1.83 times of opportunity the accuracy was. The lesion size and lesion characteristics were independent correlated factors of EUS-FNA positive rate (OR=2.012, P=0.000; OR =10.218, P=0. 002). The positive rate of EUS-FNA in solid lesions was 10. 2 times of that in cystic lesions. Lesion size was the independent correlated factors of EUS-FNA diagnostic accuracy (OR =1. 984, P =0. 015 ). ConclusionEUS-FNA can effectively make a pathological diagnosis of pancreatic masses with high diagnostic accuracy and specificity. EUS-FNA diagnostic positive rate and accuracy were both positively correlated with pancreatic lesion size. EUS-FNA positive rate of solid pancreatic lesions is significantly higher than that of cystic lesions.

OBJECTIVETo investigate the effect(s) of interleukin-1beta (IL-1beta) on the activity of human growth hormone (hGH) gene promoter in rat pituitary GH3 cells and the molecular mechanism.

METHODSThe method of luciferase reporter gene was used. We firstly established stable GH3 cell line which contains hGH gene promoter -484-30 bp and luciferase reporter gene. After treating these cells with IL-1beta or IL-1beta plus various signaling transduction inhibitors, the concentration of GH in the medium and lysate of GH3 cells and luciferase activities in GH3 cells were measured to reflect the effect of IL-1beta on secretion and synthesis of GH and the promoter activity of the hGH gene and the molecular mechanism. Results IL-1beta (10-10(4)U/ml) increased secretion and synthesis of GH. IL-1beta at levels of 10(2)-10(4) U/ml promoted the luciferase expression in stable GH3 cells, and the maximal action was 1.61 times of the control (P < 0.001). Among the inhibitors of intracellular signaling transduction pathways, mitogen-activated protein kinases (MAPK) inhibitor PD98059 (40 micromol/L) and p38 MAPK inhibitor SB203580 (5 micromol/L) completely blocked the stimulatory effect of IL-1beta, and phosphoinositide 3-kinase (PI3-K) inhibitor LY294002 (10 micromol/L) partly blocked the induction of IL-1beta. Neither overexpression of Pit-1 nor inhibiting Pit-1 expression affected IL-1beta induction of hGH promoter activity. The stimulatory effect of IL-1beta was abolished following deletion of the -196 to -132 bp fragment.

CONCLUSIONSIL-1beta increases the activity of hGH gene promoter in rat pituitary GH3 cells. This stimulatory effect of IL-1beta appears to require the intracellular MAPK, p38 MAPK, and PI3-K dependent signaling pathways. The effect of IL-1beta requires the promoter sequence that spans the -196 to -132 bp fragment of the gene, but it is unrelated to Pit-1 protein.

Animals ; Cell Line ; Chromones ; pharmacology ; Flavonoids ; pharmacology ; Genes, Reporter ; Growth Hormone ; biosynthesis ; genetics ; Humans ; Interleukin-1 ; pharmacology ; Luciferases ; metabolism ; Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; Morpholines ; pharmacology ; Phosphatidylinositol 3-Kinases ; antagonists & inhibitors ; Pituitary Gland ; cytology ; enzymology ; metabolism ; Rats ; Signal Transduction ; p38 Mitogen-Activated Protein Kinases

OBJECTIVETo evaluate the efficiency of navigation system for orbital wall reconstruction in unilateral orbital fractures.

METHODSFifteen patients (7 male and 8 female) with unilateral orbital fracture underwent orbital reconstruction with the help of intraoperative navigation system. The average age was 34.3 ± 9.5 years. All patients underwent spiral CT scanning preoperatively, and the CT data was imported to the BrainLab navigation system (Germany, BrainLab company). The orbit of the intact side was mirrored to the opposite side as the reference for pre-operative planning. The titanium mesh was mounted on the resin template made by rapid prototyping machine based on the mirrored CT data. When the injury was limited, the hydroxyapatite sheet was used for the orbital wall reconstruction. During the operation, the real-time navigation helped to ensure precise placement. The re-establishing result was assessed based on the postoperative CT data with the following four variables: the volumetric difference between the bilateral orbit, the volume of the herniated soft tissue, the global projection and the discrepancy between the simulated and the achieved position of the reconstructed orbital wall. The reconstructive discrepancy was measured only in the titanium plate grafting cases.

RESULTSThere were no serious complications such as infection, graft rejection and optic nerve injury in any case. Preoperatively, the average degree of enophthalmos was (3.5 ± 1.6) mm, the average volumetric difference between the injured and the unaffected orbit was (4.5 ± 1.8) ml, and the average volume of the herniated orbital soft tissue was (2.1 ± 0.7) ml. Postoperatively, the three values were respectively reduced to (1.3 ± 0.6) mm, (1.8 ± 0.9) ml and (0.7 ± 0.3) ml. The discrepancy of the medial and inferior wall were (2.5 ± 0.6) mm and (2.1 ± 0.4) mm.

CONCLUSIONSThe intraoperative use of navigation system for the orbital wall reconstruction in unilateral orbital fractures can provide reliable accuracy and achieve satisfactory results.

Adult ; Computer Simulation ; Enophthalmos ; diagnostic imaging ; etiology ; surgery ; Female ; Humans ; Male ; Orbit ; diagnostic imaging ; surgery ; Orbital Fractures ; complications ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed

OBJECTIVETo investigate the value of computer aided navigation system (CANS) in the treatment of post traumatic maxillofacial deformation.

METHODSFifty-four patients (M = 37, F = 17) were included in the study, including 31 cases of zygomatic fracture, 7 cases of pure orbital fracture, 11 cases of temporal mandibular joint ankylosis, 1 case of foreign body and 4 cases of defect reconstruction with custom implant. Data acquisition was done through CT scan, and DICOM data was transferred into workstation. Computer assisted design, including osteotomy, reposition, fibula flap design, orbital implant construction was performed using Surgicase CMF and Brain Lab Iplan system. The virtual design was transferred to Brain Lab navigation system, and the osteotomy, reduction, location of bone graft and custom implant were guided by navigation. Postoperative CT scan was required 48 - 72 hours after surgery. Preoperative and postoperative CT images were superimposed automatically in BrainLab Iplan system, and compared both in 3D objects and 2D slices.

RESULTSAll the cases achieved good results without serious complication. The error of important corresponding points in zygomatic fracture reduction, orbital reconstruction and defect reconstruction was 0.2 - 3.5 mm, 0.8 - 2.0 mm and 0.2 - 2.2 mm respectively.

CONCLUSIONSComputer assisted design is of considerable value for the systematic and accurate planning for complicated post traumatic deformation. Virtual plan could be carried out accurately with the assistance of CANS.

Adult ; Computer Simulation ; Computer-Aided Design ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Orbital Fractures ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed ; Tooth Ankylosis ; diagnostic imaging ; surgery ; Young Adult ; Zygomatic Fractures ; diagnostic imaging ; surgery

OBJECTIVETo study the correlation between vitamin D receptor genetic polymorphism Fokand vitamin D deficiency rickets in children between 1 to 3 years old, and to explore the significance of hereditary factors in the development of vitamin D deficiency rickets.

METHODSSixty-two children with vitamin D deficiency rickets and 60 healthy children as a control group were enrolled. Serum levels of 25-hydroxyvitamin D3 were measured using ELISA. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genetic analysis method was used. A restriction fragment length polymorphism in the vitamin D receptor genetic polymorphism Fok I was tested. The frequencies of the vitamin D receptor genotype and allele were compared between the two groups.

RESULTSSerum 25-hydroxyvitamin D3 levels in the rickets group were significantly lower than those in the control group ( 9.1+/-4.1 ng/mL vs 16.1+/-6.9 ng/mL; P<0.05 ). FF genotype in the vitamin D receptor genetic polymorphism Fok I was more common in the rickets group than in the control group (53% vs 25%; P<0.05). F allele frequency in the rickets group was significantly higher than that in the control group (73% vs 57%; P<0.05).

CONCLUSIONSThere is a correlation between vitamin D receptor genetic polymorphism Fok I and vitamin D deficiency rickets. This suggests that vitamin D receptor genetic polymorphism might play an important role in determining susceptibility to development of vitamin D deficiency rickets.

Calcifediol ; blood ; Child, Preschool ; Female ; Genetic Predisposition to Disease ; Humans ; Infant ; Male ; Polymorphism, Genetic ; Receptors, Calcitriol ; genetics ; Rickets ; blood ; genetics