OBJECTIVETo compare the efficacy of two surgical techniques for controllong nasal width after Le Fort I osteotomy.

METHODSFifty-five patients who received the Le Fort I osteotomy have been included in this study. They were randomly divided into 2 groups. The experimental group received extraoral ABS, and the control group received traditional intraoral ABS. 3D photos of the patient's face were taken before operation and at postoperative 3 months. Alar width was measured on the 3D photos. Data was reported as means and standard deviations, and statistic analysis was done by using student t test.

RESULTSCompared with presurgical data, G. lat-G. lat increased by (2.66 +/- 1.47) mm, Al-Al increased by (2.20 +/- 1.22) mm and Sbal-Sbal increased by (1.30 +/- 1.33) mm in experimental group. G. lat-G. lat increased by (1.38 +/- 1.29) mm, Al-Al increased by (1.06 +/- 0.95) mm and Sbal-Sbal increased by (0.36 +/- 1.33) mm in the control group. There was significant difference between two groups.

CONCLUSIONSThe surgical technique of ABS is the most important factor for determining the postoperative alar width. Both techniques have better effect on the Sbal-Sbal width control than the G. lat-G. lat and Al-Al width control. Traditional intraoral ABS can more effectively control the alar width. Both techniques cannot completely control the alar base widening after Le Fort I osteotomy.

Face ; Humans ; Nose ; anatomy & histology ; Nose Deformities, Acquired ; surgery ; Osteotomy, Le Fort ; adverse effects ; Photography

The clinical thinking modes of "integrative disease and Syndrome" and "integrative macroscopical Syndrome-differentiation and microscopical Syndrome-differentiation" formed in the past half century were merely the primary train of thought and methodology of integrative traditional Chinese and Western medicine. In order to develop them to a higher level, stress should be put on the unity and holism of disordered organism and unity of function, structure and metabolism. It has long been ignored that a parallel and correlated relationship exists between the TCM Syndrome and pathological process of Western medicine, which is a common, set-formed and regular pathophysiological changes with certain development phase, presented in various diseases. Both have common features as that the same pathological process can be seen in different diseases and several pathological progresses can present in one disease, the same Syndrome also can be seen in different diseases and several Syndromes can present in a disease. Moreover, they have the compatible connotation and denotation. The author deduced that pathophysiological basis of main Syndrome is indeed the basic pathological process. Essence of Syndrome is the related pathological processes including abnormal changes in function, metabolism and morphological structure.
Biomedical Research ; methods ; Clinical Medicine ; methods ; Drug Therapy, Combination ; Holistic Health ; Humans ; Medicine, Chinese Traditional ; methods ; Pathology, Clinical ; methods

To study the telomerase activity in the bone marrow MNCs from patients with myelodysplastic syndromes in comparison with that in normal individuals and acute leukemia patients. The intracellular telomerase activity was semi-quantitatively examined by PCR-ELISA assay in the marrow cells of 20 normal individuals, 21 cases of myelodysplastic syndromes (MDS) and 32 cases of acute leukemia. Telomerase activity in normal marrow cells was 0 - 0.30 U, with a mean level of (0.11 +/- 0.08) U, in which 3 cases were considered positive according to the standard set by the Kit. In 32 acute leukemia patients, the mean level of telomerase activity was (0.42 +/- 0.26) U (ranged 0 - 0.96 U) with a positive rate of 78.1%, showing a significantly higher activity in acute leukemia (P < 0.01). Moderate telomerase activity was detected in 21 cases of MDS, with a mean level of (0.27 +/- 0.19) U (0 - 0.97 U) from which the positive rate was 66.7%. This value was significantly higher than that in the normal BM (P < 0.05). Moreover, a significantly higher telomerase activity was shown in the high-risk group of MDS (P < 0.05). Based on the international scoring system evaluating the prognosis of MDS (IPPS), telomerase activity in HIGH subgroup was significantly higher than that in INT-1 and INT-2 subgroup (P < 0.05). The level of telomerase activity was not correlated to the chromosome aberrations. These results show that a borderline telomerase activity could be found in normal bone marrow cells. Telomerase activity was markedly higher in acute leukemia. BM of MDS patients demonstrated a moderate telomerase activity. Higher telomerase activity could be found in high-risk group and correlated with poor prognosis.

OBJECTIVETo study the application of distraction osteogenesis (DO) of the mandibular ramus in hemifacial microsomia.

METHODSFrom 1999 to 2006, 15 patients with hemifacial microsomia were treated with DO of the ramus, including 12 cases of children and juveniles, 3 cases of grown-ups. Maxillary Le Fort I osteotomy, unilateral sagittal split ramus osteotomy, genioplasty and free scapular flaps were selected to perform on the first or secondary stage of treatment.

RESULTSSuccessful distraction was achieved in all patients with an average distraction distance of 21.25 mm. The distractor was removed after consolidation proved by clinical examination and X-ray. Facial appearance and and occlusal relationship were improved greatly. The occlusal plane was almost normal. There was no infection, malunion or permanent injury of inferior alveolar nerve.

CONCLUSIONSDO of the ramus is very effective for the correction of severe hemifacial microsomia. It has much better therapeutic effect than traditional orthognathic procedures.

Adolescent ; Adult ; Child ; Child, Preschool ; Facial Asymmetry ; surgery ; Female ; Humans ; Male ; Mandible ; surgery ; Osteogenesis, Distraction ; methods ; Young Adult

OBJECTIVETo study the incidence of injuries among residents living in the communities in Zhejiang.

METHODSA household questionnaire survey was conducted to 16 899 residents in four communities.

RESULTSThe incidence of injuries was 16.11% in total, higher in urban area than in rural area and higher in men than in women. The leading causes of injuries were falls (4.80%), knife-cutting or by sharp articles (3.86%), traffic accident (2.07%), collision (1.99%), scalds (1.13%) and animal bites (1.06%). Peak incidence of age group was different in different injuries, such as traffic accident was high in 45 - 60 age group and falls was high in 5 and 60 age group. Direct economic loss for each case with injury would cost 324.21 RMB yuan.

CONCLUSIONInjury was common and frequently occurred among residents at the community level which seriously on danger their health and families.

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Animals ; Bites and Stings ; epidemiology ; Burns ; epidemiology ; Child ; China ; epidemiology ; Community Health Services ; Dogs ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Wounds and Injuries ; epidemiology ; mortality

OBJECTIVETo investigate the association of the haplotypes and genotype combinations of vitamin D receptor (VDR) BsmI (rs1544410), Tru9I (rs757343), ApaI (rs7975232), and TaqI (rs731236) with the susceptibility to elevated blood lead in Chinese Han population.

METHODSAccording to Diagnostic Criteria of Occupational Chronic Lead Poisoning (GBZ 37-2002) and Occupational Exposure Limits for Hazardous Agents in the Workplace Part 1: Chemical Hazardous Agents (GBZ 2.1-2007), the workers were divided into high-exposure group (lead dust ≥ 0.05 mg/m(3), lead fume ≥ 0.03 mg/m(3)) and low-exposure group based on the concentrations of lead fume and lead dust in the workplace. The high-exposure group was further divided into normal-blood lead subgroup and high-blood lead subgroup. Fasting peripheral venous blood (5 ml) was collected using a heparin tube; genomic DNA was extracted from the peripheral blood cells with a Qiagen kit; single nucleotide polymorphisms were detected by allelic discrimination assay using TaqMan probes (carrying fluorescent dyes); haplotypes were analyzed and compared by Haploview.

RESULTSVDR BsmI, Tru9I, ApaI, and TaqI were in Hardy-Weinberg equilibrium between the normal-blood lead subgroup and high-blood lead subgroup (P > 0.05). Compared with haplotype CCCA which had the highest distribution frequency, haplotypes CCAA and CTCA were the high-risk factors for elevated blood lead (OR = 1.814, 95%CI = 1.055 ∼ 3.119; OR = 1.919, 95%CI = 1.040 ∼ 3.540). Compared with genotype combination CC + CC + CC + AA which had the highest distribution frequency, genotype combination CC + CC + AC + AA was the high-risk factor for elevated blood lead (OR = 2.800, 95%CI = 1.282 ∼ 6.116).

CONCLUSIONAs for VDR BsmI, Tru9I, ApaI, and TaqI, haplotypes CCAA and CTCA and genotype combination CC + CC + AC + AA are associated with the susceptibility to elevated blood lead.

Adolescent ; Adult ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Lead ; blood ; Male ; Middle Aged ; Occupational Exposure ; Polymorphism, Single Nucleotide ; Receptors, Calcitriol ; genetics ; Young Adult

BACKGROUNDInteractions of tumor cells with the microenvironment were deemed to promote the tumor invasion and metastasis. CXC chemokine receptor 4 (CXCR4) and extracellular matrix metalloproteinase inducer (EMMPRIN) had reported to participate in this process. However the roles of bone marrow microenvironment in leukemic infiltration were not well investigated.

METHODSA co-culture system between SHI-1 cells and bone marrow stromal cells (BMSCs) is used to simulate the interactions of leukemic cells with their microenvironment. The trans-matrigel invasion was used to detect the capability of SHI-1 cells invasion. The BMSCs and SHI-1 cells were mixed in a ratio of 1:10 and added to the millicell chamber coated with matrigel. Either the co-culture supernatant or the functional blocking peptide of CXCR4 and EMMPRIN were added to the trans-matrigel invasion system. The expressions of EMMPRIN in SHI-1 cells and BMSCs were detected by RT-PCR. The changes of the expression of matrix metalloproteinase-2, 9 (MMP-2, MMP-9), tissue inhibitor of metalloproteinase 2 (TIMP-2), and CXCR4 mRNA in SHI-1 cells were determined by real-time PCR. The concentration of stromal cell derived factor 1 (SDF-1) in serum free supernatant was measured by ELISA.

RESULTSBoth SHI-1 cells and BMSCs express EMMPRIN. SHI-1 cells could hardly invade the matrigel membrane; the coculture supernatant did not induce the invasion of SHI-1 cells. When contacting directly with BMSCs, SHI-1 cells invaded to the lower chamber of millicell were significantly increased. The functional blocking peptide of CXCR4 and EMMPRIN could significantly inhibit the invasion triggered by BMSCs. When co-culturing with BMSCs, the expression of CXCR4, MMP-2, MMP-9 and TIMP-2 mRNA in SHI-1 cells were significantly elevated in company with a significantly higher level of SDF-1 in the co-cultured serum-free supernatant.

CONCLUSIONThe interactions of leukemic cells and BMSCs play important roles in leukemic cell infiltration.

Basigin ; physiology ; Cell Communication ; Cell Line, Tumor ; Coculture Techniques ; Humans ; Leukemia, Monocytic, Acute ; pathology ; Mesenchymal Stromal Cells ; physiology ; Neoplasm Invasiveness ; Receptors, CXCR4 ; physiology

OBJECTIVETo evaluate the feasibility and the therapeutic effect of orthognathic surgical procedures combined distraction osteogenesis and scapular flap for correction of progressive hemifacial atrophy.

METHODS5 cases with progressive hemifacial atrophy were treated. 1 mild case was treated with microsurgical de-epithelia scapular flap (MDSF) and genioplasty in one stage. The 2 moderate cases were treated with Le Fort 1 osteotomy following by sagittal split ramus osteotomy and genioplasty at the first stage. 3 - 6 months later, the MDSFs were used for augmentation. 2 sever cases were treated with bimaxillary distraction osteogenesis on the affected side. 3 - 4 months later, the distraction devices were removed and MDSFs were transplanted.

RESULTSThe facial asymmetry was obviously improved. The orthognathic procedures and distraction osteogenesis achieved good therapeutic effect. All the MDSFs were survived.

CONCLUSIONSThe progressive hemifacial atrophy can result in very severe deformity when it occurs in very young age. The combined deformity of bone and soft tissue can be effectively corrected by orthognathic procedures combined with distraction osteogenesis and scapular flap transplantation.

Adolescent ; Facial Hemiatrophy ; surgery ; Female ; Humans ; Male ; Osteogenesis, Distraction ; Skin Transplantation ; Surgical Flaps

OBJECTIVETo approach the treatment of severe micrognathia accompanying obstructive sleep apnea hypopnea syndrome (OSAHS) with rigid external distractor (RED) in children.

METHODSSix cases patients (4 males, 2 females) aged between 1.5 and 14 years, were diagnosed as ankylosis of temporomandibular joint severe micrognathia, and OSAHS. Under the nasal intubation and general anesthesia, the surgical procedures were performed by submandibular approach and osteotomy was done in mandible body. Mini plate was fixed and connected to RED. The distraction procedure was carried out

RESULTSPatients' profile, posterior airway space, and the results of polysomnography were improved significantly. There were no complications. Four months after removing the RED, the new bone was well formed.

CONCLUSIONSRED technique has advantages of uncomplicated procedures, high quality of new bone formation, and accurate regulation in the treatment of micrognathia. It is especially suitable for the treatment of children with severe micrognathia whose mandibular body is too small to insert the internal distractor.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Mandible ; surgery ; Micrognathism ; complications ; surgery ; Osteogenesis, Distraction ; methods ; Sleep Apnea, Obstructive ; complications ; surgery ; Temporomandibular Joint Disorders ; complications ; surgery ; Treatment Outcome

OBJECTIVETo discuss the indication and protocol of surgical therapy when treating mandibular micrognathism accompanying obstructive sleep apnea-hypopnea syndrome (OSAHS) using distraction osteogenesis and orthognathic surgery.

METHODSA total of 17 patients with mandibular micrognathism accompanying moderate to severe OSAHS, aged 11 to 59 years, 15 men and 2 women, were reviewed. Four of them were treated with orthognathic surgery, 5 of them were treated with distraction osteogenesis, and the other 8 patients were treated with an integrated procedure combining distraction osteogenesis with orthognathic surgery. Cephalometric analysis and polysomnography studies were obtained pre- and postoperatively.

RESULTSSNB angle changed from 64.6 degrees to 71.9 degrees, post airway space (PAS) from 5.4mm to 13.2 mm, apnea and hypopnea index (AHI) from 58.4 to 7.6, lowest saturation of oxygen (LSAT) from 66% to 87%. All the differences showed statistical significance (P < 0.001). The average mental horizontal advancement (MHA) was 14.3 mm and its correlation coefficients with deltaSNB, deltaPAS, deltaAHI, and deltaLSAT were 0.36, 0.62, 0.34, and -0.14, respectively.

CONCLUSIONSBoth distraction osteogenesis and orthognathic surgery can be effectively used to treat patients with mandibular micrognathism accompanying OSAHS with slightly different indications. A combination of these two operations may be preferred.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Mandible ; surgery ; Micrognathism ; complications ; surgery ; Middle Aged ; Osteogenesis, Distraction ; Sleep Apnea, Obstructive ; etiology ; surgery