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 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 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 evaluate the clinical effect of distraction osteogenesis for patients with mandibular micrognathia secondary to temporomandibular joint (TMJ) ankylosis.

METHODS43 patients (aged from 2 to 61 years old) with mandibular micrognathia were treated with mandibular distraction osteogenesis. Two types of mechanical distraction were utilized in this study. Ten patients (age ranged from 2 to 16-years-old, mean age 7.6 years old) with severe micrognathia underwent bilateral mandibular distraction with rigid external distraction (RED) device. Other 33 patients were treated with unilateral(6 cases) or bilateral (27 cases) mandibular distraction using internal distraction device. Distraction was started on the 4th to 8th day after operation and distraction rate was 0.25 mm every time, four times a day. Distractor was removed after 3 to 6 months of consolidation period.

RESULTSEighty sides of mandible in 43 patients were lengthened. The mean distraction distance was 23.2 mm (ranged from 14 to 35 mm). After distraction, the average posterior airway space (PAS) was enlarged from 4.9 mm to 10.4 mm and average angle of sella-nasion-point B (SNB) was increased from 64.2 degrees to 74.5 degrees. The apnea hypopnea index (AHI) was decrease significantly. The profile was improved and OSA was improved effectively in each patient. No complication occurred during treatment. No persistent numbness of lower lip was observed. All patients were satisfied with the results. After a mean follow-up period of 20.3 months(5 to 103 months) , the result was stable and no obvious relapse of micrognathia was observed.

CONCLUSIONSDistraction osteogenesis is an effective way in correction of mandibular micrognathia secondary to TMJ ankylosis. RED is a new method for treatment of children and adolescence with severe mandibular micrognathia. The procedure is simple and safe with stable result.

Adolescent ; Adult ; Ankylosis ; complications ; Child ; Child, Preschool ; Humans ; Mandible ; surgery ; Micrognathism ; etiology ; surgery ; Middle Aged ; Osteogenesis, Distraction ; instrumentation ; methods ; Sleep Apnea, Obstructive ; surgery ; Temporomandibular Joint ; Temporomandibular Joint Disorders ; complications ; Young Adult

OBJECTIVECondylectomy was performed to treat condylar osteoma or hyperplasia. Introduced two methods of condylectomy via intraoral approach and evaluated their clinical results.

METHODSThirty-five patients, aging from 22 to 57.21 years, were treated by condylectomy via intraoral approach, of which 21 were condyle osteoma, 14 hemimandibular hyperplasia and condylar hyperplasia. Intraoral vertical ramus osteotomy (IVRO) were used in 32 patients and intraoral condylectomy via coronoid process resection was used in 3 patients.

RESULTSThe treatment results including oral function and facial symmetry after the operation were good in all patients. The temporomandibular joint (TMJ) dysfunction syndrome alleviated or disappeared. The follow-up period was 6 months to 3 years, and no relapse of condylar osteoma or hyperplasia was found. The patients who had IVRO and TMJ reconstruction had some degree of transplanted bone resorption, and one patients had relapse of facial deformity. But the patients who had intraoral condylectomy via coronoid process resection only had mild condyle remodeling and no obvious bone resorption was noted.

CONCLUSIONSThe two methods of intraoral condylectomy introduced in this stugy can successfully correct the facial deformity and TMJ dysfunction caused by condylar osteoma or hyperplasia. But the surgeons need to have excellent surgical skills and careful selection of the indications.

Adult ; Facial Asymmetry ; surgery ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Male ; Mandible ; diagnostic imaging ; pathology ; surgery ; Mandibular Condyle ; diagnostic imaging ; pathology ; surgery ; Mandibular Neoplasms ; diagnostic imaging ; pathology ; surgery ; Middle Aged ; Oral Surgical Procedures ; methods ; Osteoma ; diagnostic imaging ; pathology ; surgery ; Temporomandibular Joint ; physiology ; surgery ; Temporomandibular Joint Disorders ; surgery ; Tomography, X-Ray Computed ; 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 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

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