Objective:To evaluate the surgical corrective results of maxillary hypoplasia in patients with cleft lip and palate withtranspalatal modified Le Fort Ⅰ osteotomy.Methods:In the study,1 1 patients (4 women,and 7 men)with maxillary hypoplasia secondary to cleft lip and palate underwent transpalatal modified Le Fort Ⅰ osteotomy at Peking University School of Stomatology from Jan.201 2 to Dec.201 3, with the mean age of 21 years (from 1 8 to 27 years),Bilateral sagittal split ramus osteotomy (BSSRO) and genioplasty were performed simultaneously in 9 of them for better appearance and functional occlu-sion.Lateral cephalometric radiographs were taken and traced before surgery,immediately after surgery and 6 months after surgery.The position of subspinale (A)on horizontal direction,the angle of sella-na-sion-subsipmale (SNA)and the angle of sella-nasion-supramental (SNB)were collected and analyzed to evaluate the results.Results:All the patients were uneventful with transpalatal modified Le Fort Ⅰosteotomy.All of them had a better profile and a satisfactory occlusionafter operation.The position of A was moved forward (6.6 ±1 .1 )mm on average in horizontal direction when surgery was completed,and maintained (6.0 ±1 .2)mm on average 6 months after surgery.The average of SNA was 75.9°±2.8° before surgery,81 .6°±8.6°immediately after surgery,and maintained 81 .0°±2.6°6 months after sur-gery.The average of SNB was 82.6°±3.7°before surgery,78.0°±2.4°immediately after surgery,and maintained 78.5°±2.4°6 months after surgery.Conclusion:The maxillary hypoplasia in cleft lip and palate patients can be successfully corrected with transpalatal modified Le Fort Ⅰ osteotomy and the func-tional occlusion can be achieved simultaneously.The effect of deformity correction was satisfactory. Transpalatal modified Le Fort Ⅰ osteotomy can move maxilla more sufficiently,especially applicable for the patient with severe palatal scars preoperatively.

Aim To study the analgesic effect of geraniol on neuropathic pain and to explore the possible mechanism.Method A neuropathic pain rat model of Spared Nerve Injury(SNI) was established to measure changes in the threshold of paw withdrawal before and after i.p.administration of geraniol.Patch clamp whole-cell recording was performed to measure activity of sodium channels using ipsilateral L3/L4/L5 dorsal root ganglion(DRG) cells isolated from the SNI rats.In addition, HEK 293 cells expressing hNav1.7 and hTRPA1 channels were used for measuring the changes in channel activities with or without geraniol by whole-cell patch clamp.Results Geraniol had a fast analgesic effect on hypersensitivity of mechanical pain in the SNI model.It significantly inhibited sodium channels on DRGs isolated from SNI rats and hNav1.7 but not hTRPA1 channels expressed by HEK293 cells.However, high concentrations of geraniol facilitated the activation of HTRPA1 channel stimulated by AITC.Conclusion Geraniol may abirritate hypersensitivity of mechanical pain in the SNI model by specifically inhibiting Nav1.7 channel activity on the DRG cells.

Objective: To investigate the effect of icariin on the proliferation, differentiation, and the mRNA expressions of Cbfαl, BMP2, BMP4 of rat osteoblasts. Methods: Primary rat osteoblastic cells were obtained by sequentia collagenase/trypsin enzyme digestion from calvarial bones of new born ( within 24 h) SD rats and were identified by Alkaline phosphatase and alizarin red staining. The passage 3-5cells were treated with icariin at the concentration of 0 mol/L, 10~(-8)mol/L, 10~(-7)mol/L, 10~(-6)mol/L,10~(-5)mol/L, 10~(-4)mol/L for 24 h, 48 h, 72 h, and the proliferation of the cells was measured by CCK-8assay. The proliferation index was detected by Flow Cytometry and the activity of alkaline phosphatase was determined by p-Nitrophenyl phosphate (pNPP) method after being treated with icariin at the concentration mentioned above for 48 h. The total cellular RNA was extracted 48 h after being treated with icariin at the concentration of 10~(-6)mol/L, and the expressions of Cbfα1, BMP2, BMP4 mRNA were examined by real-time PCR. Results: Icariin showed no effect on the proliferation of osteoblasts, but improved ALP activity. The Cbfα1, BMP2, BMP4 mRNA were significantly upregulated after icariin treatment. Conclusion: Icariin could promote the differentiation ability of rat osteoblasts through upregulating the Cbfα1, BMP2, BMP4 mRNA expressions.

BACKGROUND:Stem cel transplantation has gained considerable support recently. It provides new opportunities for treating diabetic neurogenic bladder. OBJECTIVE:To summarize the research progress in bone marrow mesenchymal stem cel s (BMSCs)transplantation in the treatment of diabetic neurogenic bladder. METHODS:The first author retrieved Sciencedirect, PubMed, Embase, Wangfang and CNKI databases, for relevant articles of BMSCs transplantation in the treatment of diabetic neurogenic bladder, published from 2000 to 2016. The key words were“bone marrow mesenchymal stem cel s, diabetic neurogenic bladder, differentiation, transplantation”in Chinese and English, respectively. RESULTS AND CONCLUSION:In patients with diabetic neurogenic bladder, the transplantation of BMSCs may provide safer and longer-lasting outcomes by repairing the damaged bladder and urethra. And it can produce various bioactive substances, which wil have nutritional paracrine effects on the bladder microenvironment, including anti-inflammation, promoting cel proliferation and improving cel survival. On the one hand, the BMSCs have the ability to migrate to the injury site via the blood circulation. On the other hand, BMSCs can produce various growth factors, as wel as the cytokines that can inhibit the inflammatory response. While the current clinical studies are lacking, its efficacy and safety needs further verification.

Objective:To investigate the effect of segmental Le FortⅠosteotomy and bilateral sagittal split ramus osteotomy ( BSSRO ) on the condyle position in skeletal class Ⅲ malocclusion patients . Methods:In this retrospective study , 19 patients with skeletal class Ⅲmalocclusion who met the inclu-sion criteria were enrolled .All the patients underwent the segmental Le FortⅠ osteotomy and BSSRO . Cone beam computed tomography ( CBCT) scans were performed in the following phases:T1:within one week before the surgeries;T2:within one week post-surgery;T3:three months post-surgery;T4:6 to 14 months post-surgery .The posterior spaces , anterior spaces and the superior spaces of the bilateral tem-poromandibular joints were measured according to the Kamelchuk method respectively .The fossa ratios of the condyle and the distribution of the condyle positions related to the glenoid fossa ( anterior , concentric and posterior position ) were calculated .The results were analyzed statistically .Results:The posterior space , the anterior space and the superior space of bilateral temporomandibular joints in T 2 phase [ right:(2.78 ±1.23) mm, (2.47 ±0.89) mm, (3.07 ±0.85) mm; left: (2.93 ±0.83) mm, (2.69 ± 1.14) mm, (3.44 ±1.16) mm] showed significantly larger spaces than those in T 1 phase [right:(1.81 ±0.95) mm, (1.65 ±0.55) mm, (2.13 ±0.52) mm;left:(2.12 ±1.05) mm, (1.79 ±0.59) mm, (2.15 ±0.93) mm],in T3 phase [right:(2.08 ±1.25) mm, (1.79 ±0.68) mm, (1.80 ±0.76) mm;left: (2.05 ±0.75) mm, (1.99 ±0.94) mm, (2.14 ±0.71) mm] and in T4 phase [right:(1.94 ±0.77) mm, (1.81 ±0.69) mm, (2.05 ±0.69) mm;left:(1.89 ±0.69) mm, (1.80 ±0.61) mm, (2.19 ±0.75) mm], P<0.05.No significant differences were observed among T 1,T3 and T4 pha-ses in the terms of the joint spaces of both sides ( P >0.05).The fossa ratio and the condyle position related to the glenoid fossa had no significant difference in all the four phases (P>0.05).The results suggested that the condyle moved downward in T 2 phase and changed to the original pre-surgery position in T3 phase, then keot stable in T4 phase.Conclusion:Segmental Le FortⅠ osteotomy and BSSRO caused significant and transient changes of the condyle position in skeletal class Ⅲmalocclusion patients . However , the condyle tended to move back to the original pre-surgery position and might keep stable .

Objective To evaluate the surgical corrective results of prominent mandibular angle with masseter muscle hypertrophy by using intraoral approach. Methods One hundred and twenty three cases with various degrees of prominent mandibular angle with masseter muscle hypertrophy were treated through intraoral approach. The basic surgical procedures included masseter muscle reduction (type Ⅰ), mandibular angle osteotomy (type Ⅱ) and angle-splitting osteotomy (type Ⅲ). The type Ⅰ was completed in 4 cases, type Ⅱin 16 cases, type Ⅲ + type Ⅰ in 56 cases, type Ⅲ in 19 cases, type Ⅲ + type Ⅰ in 9 cases, type Ⅲ + type II in 12 cases, type Ⅲ + type Ⅱ+ type Ⅰ in 7 cases. Genioplasty was simultaneously performed in 69 cases.Results The overwidth of the lower face was effectively corrected. The cosmetic results, as determined by both patients and surgeons, were good. No complications, such as facial never injury, or inferior alveolar never injury, occurred in any patients. Conclusions In order to reach good cosmetic results at the patients' lateral view and frontal view, considerations should be determined according to the degrees of the deformities and patient's desires, to choose suitable surgical procedures.

OBJECTIVETo evaluate the influence of mandibular distraction osteogenesis on inferior alveolar nerve function.

METHODS16 young Macaca rhesus monkeys were used as experiment animals. 5 days after mandibular osteotomy under general anesthesia, 10 male monkeys were distracted at right side and 6 females were bilaterally distracted at a rate of 0.5 mm x 2/day, for 15 days. The mandible was lengthened to an average of 13.5 mm. The Sensory Nerve Action Potential (SNAP) test was successfully applied in 16 monkeys before operation and at 0, 2, 4, 6, 9 and 12 weeks after distraction finished. Eight-channel EMG equipment was used for SNAP wave recording. The recordings were made with needle electrodes at foramen ovale and the stimulation was done at the mental foramen with two surface electrodes. The metal ground electrode was fixed on the right forearm. The stimulation intensities were five times of thresholds of each animal. The latency was measured at the first wave peak and the amplitude was measured between two wave peaks.

RESULTSJust after distraction finished, the latency period was 22.18% longer than before operation and gradually shortened as time lapsed. When distraction finished, the amplitude of SNAP wave was only 28.54% of that before operation, and after 12 weeks, it increased to the level of 99.84% of that before operation.

CONCLUSIONSThe mandibular distraction osteogenesis has temporary influence on the function of inferior alveolar nerve, but it is little and reversible, along with the regeneration of nerve sheath and axon, the nerve function can gradually return to normal level.

Action Potentials ; Animals ; Female ; Macaca mulatta ; Male ; Mandible ; surgery ; Mandibular Nerve ; physiology ; Nerve Regeneration ; Osteogenesis, Distraction

OBJECTIVETo introduce a series of internal distractors developed by the authors and results of experimental study and clinical trials.

METHODSBased on the demand of clinical use and experimental studies, 7 kinds and 17 types of internal distractors were developed. Required biomechanics were evaluated and animal studies were undertaken in 16 Rhesus monkeys and 12 goats with 40 distractors. Clinically, 68 Patients with 7 kinds of severe dento-gratho-facial deformities were treated with 82 distractors and the histocompatibility, stability, influence on new bone formation were evaluated.

RESULTSThe 7 kinds of distractors were State-approved products made of Titanium alloy and permitted for use in human. The pull and twist force tests demonstrated that the loading capability of them were larger than 7.8 kgf and 5.0 kgf respectively. The domestic made Grade II screw was used to transmit the moving, it was nimble, without dead point, and with a forward-backward space of < 0.1 mm. The horizontal space in between the two fixing parts was < 0.1 mm. The parallel degree of the two direction-guide rods was within 0.05 mm. Animal and clinical studies demonstrated that there was no rejection response of the tissues. There were fractures of the direction-guide rods in two early cases, the design was improved then. Other results both experimentally and clinically were satisfactory with good osteogenesis.

CONCLUSIONSThis series of domestic made internal distractors can be used satisfactorily in distraction osteogenesis for various kinds of jaw deformities. The successful production of these distractors will provide a good foundation to popularize the internal distraction osteogenesis of the jaws.

Animals ; Goats ; Humans ; Jaw ; surgery ; Macaca mulatta ; Osteogenesis, Distraction ; instrumentation

OBJECTIVETo study the potential and advantages of internal distraction osteogenesis in mandibular functional reconstruction.

METHODSThree types of mandibular distractors were used in eight patients with various mandibular defects due to tumor or cyst resection. The average age of the patients was 31.5 years old (ages ranged from 8 to 54 years). For two patients with ramus defects, specially designed distractors were used to restore the normal ramus height. In two other patients, specially designed trifocal distractors were used. In three patients, vertical distractors were used.

RESULTSAll the mandibles were successfully reconstructed in accordance with the direction and distance designed before operation except in one patient. In that patient the distal 23 mm defect failed to be corrected because of loosening of transport block fixation screws.

CONCLUSIONSMandibular defects can be successfully corrected using internal distraction osteogenesis. Performing mandibular reconstruction using distraction osteogenesis is best done at the time of tumor or cyst resection.

Adult ; Child ; Female ; Humans ; Male ; Mandible ; surgery ; Mandibular Neoplasms ; surgery ; Middle Aged ; Osteogenesis, Distraction ; instrumentation

Objective:To explore an applicative value of a 5-type precise diagnostic technique in integrated precise repair and reconstruction of digit-tip injuries.Methods:From March 2012 to June 2022, 45 digit-tip injuries (38 patients, with an average age of 33 years old) were classified under microscope on the basis of effectiveness of blood vessels remained in the severed tissue. Among the injured digits, there were 15 thumbs, 9 index fingers, 16 middle fingers, 4 ring fingers and 1 little finger. The diagnosis was categorised into 5 types according to involvement of blood vessels: Type I, injury of proper palmar digital artery (10 digits) ; Type II, injury of small artery (5 digits) ; Type Ⅲ, injury of whole vein (4 digits) ; Type IV, injury of superficial palmar arch (4 digits) ; and Type V, vessels missing (22 digits). The timing and therapeutic method of surgery were selected based on the precise classification of 5 types of diagnosis: (1) For type Ⅰ-Ⅳ injuries, 16 patients (23 digits) received in situ tissue replantation after emergency classification. Of which, type Ⅰ-Ⅱ injuries received conventional replantation, type Ⅲ injuries had replantation with arterialised vein, and type IV injuries received replantation with artery-vein shunt. (2) For the type V injuries, 22 patients (22 digits), staged and categorised flap reconstruction with toe flaps were performed. Of which, 7 were performed in emergency surgery, 12 in subemergency surgery and 3 in elective surgery. Based on the severity of defects, small tissue flaps of toe were used in reconstruction of type V injuries and following toe flaps were employed: 9 hallux nail flaps, 3 hallux nail flaps (for reconstruction of distal phalanx), 5 hallux fibular flaps, 3 hallux abdominal flaps and 2 compound tissue flaps with nail bed of the second toe. The sizes of the 45 replanted/transferred tissues flaps were 1.0 cm×0.6 cm×0.4 cm-2.2 cm×1.5 cm×0.8 cm. Donor sites directly sutured. Medical APP was applied in the rehabilitation exercises. Functions of digits were assessed by scheduled follow-ups at outpatient clinic and via remote medical APP to evaluate the clinical efficacy.Results:All small tissue blocks and (or) tissue flaps survived after replantation and (or) flap reconstruction of 45 injured digits. Postoperative follow-up lasted for 6 months to 7 years, with 36 months in average. The appearances of the reconstructed digit-tips were close to normal digits, with TPD at 3-7 mm. According to the Michigan Hand Outcomes Questionnaire (MHQ), 32 patients (37 digits) were in excellent, 5 patients (7 digits) in good, and 1 patient (1 digit) in poor, with 97.78% of excellent and good rate.Conclusion:Five-type precise diagnostic technique is the key to the integrated and precise reconstruction of digit-tip injuries. This method has been clinically validated and achieved realistic recovery from the injured digits.