1.Analysis of the effect of dosimeter wearing position on effective dose estimation among interventional radiology workers
Xuanrong ZHANG ; Wen GUO ; Xian XUE ; Pin GAO ; Kaiyi WANG ; Xuan ZHANG ; Yanqiu DING ; Xiao LUO ; Wenfang MENG ; Jun CHAO
Chinese Journal of Radiological Health 2025;34(5):687-694
Objective To evaluate the influence of the wearing position of dosimeters outside lead aprons on effective dose estimation for interventional radiology workers, analyze the differences between single and double dosimeter methods in effective dose estimation, and provide a reference for the personal dose monitoring of interventional radiology workers. Methods This study employed a combined approach of on-site monitoring and Monte Carlo simulation to evaluate the impact of the wearing position of dosimeters outside lead aprons on effective dose estimation, as well as the differences between effective doses measured using single and double dosimeters. Interventional radiology workers wore dosimeters at three positions: the neck outside the lead collar, the left chest outside the lead apron, and inside the lead apron. Effective doses were estimated using the single and double dosimeter methods specified in GBZ 128-2019 Specifications for individual monitoring of occupational external exposure, and the impact of different wearing positions on the estimation results was compared. Geant4 Monte Carlo simulations were used to model dose distributions at the neck outside the lead collar and at the left chest outside the lead apron for operators performing cardiovascular interventions under tube voltages of 70, 80, 90, and 100 kVp and exposure angles of posteroanterior (PA), anteroposterior (AP), and left anterior oblique 45° (LAO45°) positions. The study assessed the impact of dosimeter wearing position on effective dose estimation. Results Monte Carlo simulations demonstrated that neck doses consistently exceeded left chest doses across different tube voltages and exposure angles, with neck-to-chest dose ratios of 0.80-0.90. Under identical tube voltage conditions, AP showed the highest doses, followed by LAO45°, and PA demonstrated the lowest doses. The single and double dosimeter methods exhibited consistent patterns in effective dose estimation. Single dosimeter method generally yielded higher effective doses with relative deviations of 9.9% to 83%, though these deviations decreased under high tube voltages. Field monitoring data indicated that most interventional radiology workers maintained relative deviations between single and double dosimeter calculations below 6%, with neck-to-chest dose ratios of 0.95-1.1. The estimation patterns remained consistent across both methods, though single dosimeter method showed slightly higher results. Conclusion Under PA, AP, or LAO45°, the doses at the neck consistently exceeded those at the left chest. Therefore, when wearing lead protective equipment, the dosimeter should be properly positioned at the neck outside the lead collar to accurately reflect the radiation doses of surgeons. Some interventional radiology workers improperly positioned the dosimeter (intended at the neck outside the lead collar) at the left chest outside the lead apron, and this may result in an underestimation of the effective dose.
2.AI-integrated IQPD framework of quality prediction and diagnostics in small-sample multi-unit pharmaceutical manufacturing: Advancing from experience-driven to data-driven manufacturing.
Kaiyi WANG ; Xinhai CHEN ; Nan LI ; Huimin FENG ; Xiaoyi LIU ; Yifei WANG ; Yanfei WU ; Yufeng GUO ; Shuoshuo XU ; Lu YAO ; Zhaohua ZHANG ; Jun JIA ; Zhishu TANG ; Zhisheng WU
Acta Pharmaceutica Sinica B 2025;15(8):4193-4209
The pharmaceutical industry faces challenges in quality digitization for complex multi-stage processes, especially in small-sample systems. Here, an intelligent quality prediction and diagnostic (IQPD) framework was developed and applied to Tong Ren Tang's Niuhuang Qingxin Pills, utilizing four years of data collected from four production units, covering the entire process from raw materials to finished products. In this framework, a novel path-enhanced double ensemble quality prediction model (PeDGAT) is proposed, which combines a graph attention network and path information to encode inter-unit long-range and sequential dependencies. Additionally, the double ensemble strategy enhances model stability in small samples. Compared to global traditional models, PeDGAT achieves state-of-the-art results, with an average improvement of 13.18% and 87.67% in prediction accuracy and stability on three indicators. Additionally, a more in-depth diagnostic model leveraging grey correlation analysis and expert knowledge reduces reliance on large samples, offering a panoramic view of attribute relationships across units and improving process transparency. Finally, the IQPD framework integrates into a Human-Cyber-Physical system, enabling faster decision-making and real-time quality adjustments for Tong Ren Tang's Niuhuang Qingxin Pills, a product with annual sales exceeding 100 million CNY. This facilitates the transition from experience-driven to data-driven manufacturing.
3.mRNA display-enabled discovery of proximity-triggered covalent peptide-drug conjugates.
Ruixuan WANG ; Siqi RAN ; Jiabei GUO ; Da HU ; Xiang FENG ; Jixia ZHOU ; Zhanzhi ZHANG ; Futian LIANG ; Jiamin SHANG ; Lingxin BU ; Kaiyi WANG ; Junyi MAO ; Huixin LUO ; Rui WANG
Acta Pharmaceutica Sinica B 2025;15(10):5474-5485
Peptide-drug conjugates (PDCs) have emerged as a promising modality in precision oncology, enabling targeted delivery of cytotoxic payloads while minimizing off-target toxicity. The integration of covalent warheads, such as those based on sulfur(VI) fluoride exchange (SuFEx) chemistry, enhances drug-target residence time and tumor accumulation. However, existing screening methods for covalent peptide (CP) libraries require post-translational warhead conjugation, limiting throughput. Here, we present an integrated mRNA display platform that incorporates covalent warheads during ribosomal synthesis, enabling efficient screening of ultra-diverse covalent macrocyclic peptide libraries (>1013 variants). This approach, using site-specific incorporation of N-chloroacetyl-d-phenylalanine and fluorosulfate-l-tyrosine, accelerated the discovery of irreversibly binding (K i = 3.58 μmol/L) Nectin-4-targeting peptide CP-N1-N3 via proximity-triggered SuFEx. The peptide was further conjugated to cytotoxic payloads, yielding the covalent PDC CP-N1-MMAE with potent cytotoxicity (IC50 ≈ 43 nmol/L) against MDA-MB-468 cells. This platform establishes a new paradigm for precision covalent drug discovery.
4.Ziyuglycoside II suppressed the progression of osteosarcoma by coordinating estrogen-related receptor gamma and p53 signaling pathway.
Hang DU ; Dongjin WU ; Tianyu ZHANG ; Ying ZHONG ; Kaiyi WU ; Xin GUO ; Lisong SHENG ; Nana HUANG ; Chunzheng GAO ; Rong SUN
Chinese Journal of Natural Medicines (English Ed.) 2025;23(3):354-367
Osteosarcoma (OS) is the most prevalent primary malignant bone tumor affecting children and adolescents. Despite ongoing research efforts, the 5-year survival rate has remained stagnant for many years, highlighting the critical need for novel drug development to enhance current treatment protocols. Ziyuglycoside II (ZYG II), a triterpenoid saponin extracted from S. officinalis, has recently demonstrated antitumor properties. This study evaluates the antitumor effect of ZYG II on osteosarcoma and elucidates its mechanism of action through the co-regulation of p53 and estrogen-related receptor gamma (ESRRG), which inhibits disease progression. The research employs in vitro experiments using multiple established osteosarcoma cell lines, as well as in vivo studies utilizing a nude mouse model of orthotopic xenograft osteosarcoma. Additionally, ESRRG shRNA was used to construct stable ESRRG-reducing OS cell lines to investigate the molecular mechanism by which ZYG II exerts its anti-osteosarcoma effects through the co-regulation of ESRRG and p53. Results indicate that ZYG II administration led to decreased OS cell viability and reduced tumor volumes. Furthermore, cell cycles were arrested at the G0/G1 phase, while the proportion of apoptotic cells increased. Expression of p53, ESRRG, p21, Bax, Cleaved Caspase-9, and Cleaved Caspase-3 proteins increased, while expression of CDK4, Cyclin D1, and Bcl-2 proteins decreased. Multiple ZYG II and ESRRG docking patterns were simulated through molecular docking. Comparing the pharmacodynamic response of ZYG II to OS cell lines with reduced ESRRG and normal expression demonstrated that ZYG II inhibits osteosarcoma progression, induces cell cycle arrest, and promotes cell apoptosis through the coordination of p53 and ESRRG. In conclusion, ZYG II inhibits osteosarcoma progression, leads to cell cycle arrest, and promotes cell apoptosis through synergistic regulation of p53 and ESRRG.
Osteosarcoma/physiopathology*
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Tumor Suppressor Protein p53/genetics*
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Humans
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Animals
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Saponins/chemistry*
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Bone Neoplasms/physiopathology*
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Signal Transduction/drug effects*
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Cell Line, Tumor
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Mice, Nude
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Mice
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Apoptosis/drug effects*
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Receptors, Estrogen/genetics*
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Mice, Inbred BALB C
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Female
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Male
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Xenograft Model Antitumor Assays
5.Effects of Ditan Yizhi Decoction on Neuronal Morphology and FAM134B Protein Expression in Hippocampus of Vascular Dementia Rats
Mengyu GU ; Lieqian SUN ; Jia YANG ; Chao YANG ; Jie YANG ; Gaoshuai GUO ; Tanglong WANG ; Zhiwei YANG ; Kaiyi WANG ; Yanni HE ; Siyi ZHANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(8):97-102
Objective To observe the effects of Ditan Yizhi Decoction on learning and memory ability,structure of hippocampal tissue,neuronal morphology of hippocampus,and the expression of endoplasmic reticulum autophagy-related protein FAM134B in hippocampal tissue;To explore the mechanism of its therapeutic effect on vascular dementia.Methods Totally 32 SD rats were randomly divided into sham-operation group,model group,donepezil group and Ditan Yizhi Decoction group,with 8 rats in each group.The model group,donepezil group and Ditan Yizhi Decoction group were prepared with a modified permanent ligation method of bilateral common carotid arteries to create a rat model of vascular dementia,the common carotid artery was separated in the sham-operation group,but not ligated.After modeling,the donepezil group was given donepezil hydrochloride,Ditan Yizhi Decoction group was given Ditan Yizhi Decoction,and the sham-operation group and model group were given equal volume of distilled water for gavage for 4 consecutive weeks.Morris water maze experiment was used to evaluate the learning and memory ability,HE staining and Nissl staining were used to observe the morphological changes of hippocampus,ultrastructure of hippocampal neurons was observed using transmission electron microscopy,Western blot was used to detect the protein expression of FAM134B and p-FAM134B in hippocampal tissue.Results Compared with the sham-operation group,the escape latency period was prolonged of the rats in model group,and the number of crossing the original platform and the duration of stay in the target quadrant was reduced(P<0.01),the gap between neurons in CA1 region of the hippocampus increased,the cell morphology was irregular,the boundaries were blurred,the neurons shrinked,the Nissl bodies dissolved and broke,the number decreased,the endoplasmic reticulum arrangement was scattered,mitochondria swelled and deformed,and the expressions of FAM134B and p-FAM134B protein in hippocampal tissue increased(P<0.01).Compared with the model group,the escape latency period of rats in donepezil group and Ditan Yizhi Decoction group were significantly shortened,and the number of crossing the original platform and the duration of stay in the target quadrant were increased(P<0.01),the morphology and quantity of neurons in CA1 region of the hippocampus were more regular,with a decrease in neuronal pyknosis,an increase in the number of Nissl bodies,and a reduction in dissolution and fragmentation,the swelling and deformation of the endoplasmic reticulum were restored,and the expression of FAM134B and p-FAM134B protein in hippocampal tissue increased(P<0.01).Moreover,the effects of Ditan Yizhi Decoction group were better than those of the donepezil group(P<0.01).Conclusion Ditan Yizhi Decoction can improve the learning and memory ability and the morphology of neurons in vascular dementia rats.The mechanism may related to increasing the expression and phosphorylation of FAM134B protein,thereby promoting endoplasmic reticulum autophagy.
6. Expression and significance of interferon-inducible protein-10 and cytokines in patients with different infection status of tuberculosis
ZHANG Kaiyi ; LI Haiwen ; LI Mingwu ; LYU Zhengxuan ; LI Xiang ; HAN Yi ; ZHANG Le
China Tropical Medicine 2024;24(6):697-
Abstract: Objective The aim of this study was to observe the expression levels and clinical significance of peripheral blood interferon γ-inducible protein-10 (IP-10) and various cytokines in patients with different infection statuses of tuberculosis and to assess the efficacy of latent tuberculosis infection (LTBI) in the progression to active tuberculosis (ATB). Methods Seventy-six outpatient and inpatient cases from the Third People's Hospital of Kunming were collected and analyzed from March 2023 to February 2024. The patients were divided into three groups: ATB group (31 cases, 17 males, median age 33 years), LTBI group (27 cases, 17 males, median age 29 years), and healthy control (HC) group (18 cases, 11 males, median age 25 years). Peripheral blood samples from the three groups were taken and the expression levels of IP-10 and cytokines IL-6, IL-4, IL-8, IL-10, IL-12, IL-2, and TNF-α were detected using enzyme-linked immunosorbent assay (ELISA) methods. The t-test was used for normally distributed samples, while the Mann-Whitney U test was used for skewed distributions. For comparisons between multiple groups, the Kruskal-Wallis H test was first employed, followed by Dunn's multiple comparison test for pairwise comparisons. Finally, the effectiveness of each cytokine in distinguishing different population groups was analyzed. Results The expression levels of peripheral blood IP-10 were higher in the LTBI and ATB groups than in the HC group, but the area under the curve (AUC) of the receiver operating characteristic (ROC) of the subjects showed moderate sensitivity (AUC:0.7-0.9) and low specificity (AUC:0.5-0.7). The IL-6 expression levels were in the order of high to low in the ATB group, LTBI group, and HC group, where the HC group was significantly lower than the ATB and LTBI groups (F=12.15, P<0.001). The sensitivity and specificity of the ATB group were higher than those in the HC group. Conclusions IP-10 exhibits unique advantages in distinguishing different tuberculosis statuses. The predictive efficacy of a single cytokine is limited. Combining multiple cytokines such as IL-6 with clinical manifestations, a more accurate and comprehensive prediction model can be established.
7.Study of condylar resorption in hemifacial microsomia patients post-mandibular distraction osteogenesis
Kaiyi SHU ; Jiuli ZHAO ; Wei LIU ; Zhiyong ZHANG ; Baga SHAN ; Xiyuan LI ; Lunkun MA
Chinese Journal of Plastic Surgery 2023;39(1):10-18
Objective:To investigate the condylar resorption and influencing factors in post mandibular distraction osteogenesis of the hemifacial microsomia patients.Methods:This retrospective study investigated the clinical data of hemifacial microsomia patients who underwent mandibular distraction osteogenesis in the Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from October 2008 to August 2021. Three-dimensional models of pre-operation and pre-distractor extraction were created by the analysis of CT data via ProPlan CMF 3.0. The height and volume of the condyle were measured. Data were analyzed statistically. According to the changes of condylar height and volume pre- and post-operation, the condylar height resorption rate and volume resorption rate could be calculated. The volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia patients, hemifacial microsomia patients whether wearing a bite plate, prereproductive and adolescent hemifacial microsomia patients were compared with the Mann-Whitney U test. The Spearman correlation coefficient analysis was used to determine the correlations of the condylar volume resorption rate and condylar height resorption rate in the affected side with measurements of elogation distance, preoperative condylar height, patient age, and distractor remaining time in mandible. P<0.05 indicates that the difference was statistically significant. Results:Forty-seven Type-Ⅱa hemifacial microsomia patients(36 male patients, 11 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.49±2.60) years, 36 patients were in the prereproductive age(5-<10 years old), and 11 patients were in the adolescent age(10-20 years old). Forty-six Type-Ⅱb hemifacial microsomia patients(34 male patients, 12 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.93±3.43) years. Thirty-six patients were in the prereproductive age(5-<10 years-old), and ten patients were in the adolescent age(10-20 years-old). The follow-up period of Type-Ⅱa hemifacial microsomia patients was (8.49±2.60) months, and the follow-up period of Type-Ⅱb hemifacial microsomia patients was (9.79±2.59) months. Facial asymmetry was improved effectively. Surgical part of the bone had good osteogenesis. Mouth opening and closing, speech, and eating were all normal. The condylar volume resorption rate 34.8%(19.1%, 54.3%) in the affected side of Type-Ⅱa hemifacial microsomia was significantly associated with the elogation distance ( r=0.46, P=0.001), and it had no correlation with the height of the affected condyle ( r=-0.12, P=0.421), age of patients ( r=-0.06, P=0.691), and distractor remaining time in mandible ( r=-0.10, P=0.517). The condylar volume resorption rate 61.0%(11.2%, 95.0%) in the affected side of Type-Ⅱb hemifacial microsomia was significantly associated with the height of the affected condyle ( r=-0.45, P=0.002) and had weak correlation with the elogation distance ( r=0.29, P=0.049), and it had no correlation with age of patients ( r=0.06, P=0.705), and distractor remaining time in mandible ( r=0.21, P=0.157). However, there was no significant difference in terms of the condylar volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia ( z=-1.90, P=0.058). Whether the hemifacial microsomia patients wearing a bite plate following mandibular distraction osteogenesis did not affect the condylar volume resorption rate of the affected side ( z=-1.17, P=0.242 in Type-Ⅱa hemifacial microsomia, z=-0.17, P=0.869 in Type-Ⅱb hemifacial microsomia). The condylar volume resorption rate of the affected side had no significant difference between prereproductive and adolescent hemifacial microsomia patients ( z=-0.18, P=0.860 in Type Ⅱa hemifacial microsomia, z=-1.50, P=0.134 in Type-Ⅱb hemifacial microsomia). Conclusion:Condylar resorption of the affected side would happen in post mandibular distraction osteogenesis of the hemifacial microsomia patients, and the condylar resorption rate of the affected side has relationship with the elogation distance and affected preoperative condylar height.
8.Study of condylar resorption in hemifacial microsomia patients post-mandibular distraction osteogenesis
Kaiyi SHU ; Jiuli ZHAO ; Wei LIU ; Zhiyong ZHANG ; Baga SHAN ; Xiyuan LI ; Lunkun MA
Chinese Journal of Plastic Surgery 2023;39(1):10-18
Objective:To investigate the condylar resorption and influencing factors in post mandibular distraction osteogenesis of the hemifacial microsomia patients.Methods:This retrospective study investigated the clinical data of hemifacial microsomia patients who underwent mandibular distraction osteogenesis in the Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from October 2008 to August 2021. Three-dimensional models of pre-operation and pre-distractor extraction were created by the analysis of CT data via ProPlan CMF 3.0. The height and volume of the condyle were measured. Data were analyzed statistically. According to the changes of condylar height and volume pre- and post-operation, the condylar height resorption rate and volume resorption rate could be calculated. The volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia patients, hemifacial microsomia patients whether wearing a bite plate, prereproductive and adolescent hemifacial microsomia patients were compared with the Mann-Whitney U test. The Spearman correlation coefficient analysis was used to determine the correlations of the condylar volume resorption rate and condylar height resorption rate in the affected side with measurements of elogation distance, preoperative condylar height, patient age, and distractor remaining time in mandible. P<0.05 indicates that the difference was statistically significant. Results:Forty-seven Type-Ⅱa hemifacial microsomia patients(36 male patients, 11 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.49±2.60) years, 36 patients were in the prereproductive age(5-<10 years old), and 11 patients were in the adolescent age(10-20 years old). Forty-six Type-Ⅱb hemifacial microsomia patients(34 male patients, 12 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.93±3.43) years. Thirty-six patients were in the prereproductive age(5-<10 years-old), and ten patients were in the adolescent age(10-20 years-old). The follow-up period of Type-Ⅱa hemifacial microsomia patients was (8.49±2.60) months, and the follow-up period of Type-Ⅱb hemifacial microsomia patients was (9.79±2.59) months. Facial asymmetry was improved effectively. Surgical part of the bone had good osteogenesis. Mouth opening and closing, speech, and eating were all normal. The condylar volume resorption rate 34.8%(19.1%, 54.3%) in the affected side of Type-Ⅱa hemifacial microsomia was significantly associated with the elogation distance ( r=0.46, P=0.001), and it had no correlation with the height of the affected condyle ( r=-0.12, P=0.421), age of patients ( r=-0.06, P=0.691), and distractor remaining time in mandible ( r=-0.10, P=0.517). The condylar volume resorption rate 61.0%(11.2%, 95.0%) in the affected side of Type-Ⅱb hemifacial microsomia was significantly associated with the height of the affected condyle ( r=-0.45, P=0.002) and had weak correlation with the elogation distance ( r=0.29, P=0.049), and it had no correlation with age of patients ( r=0.06, P=0.705), and distractor remaining time in mandible ( r=0.21, P=0.157). However, there was no significant difference in terms of the condylar volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia ( z=-1.90, P=0.058). Whether the hemifacial microsomia patients wearing a bite plate following mandibular distraction osteogenesis did not affect the condylar volume resorption rate of the affected side ( z=-1.17, P=0.242 in Type-Ⅱa hemifacial microsomia, z=-0.17, P=0.869 in Type-Ⅱb hemifacial microsomia). The condylar volume resorption rate of the affected side had no significant difference between prereproductive and adolescent hemifacial microsomia patients ( z=-0.18, P=0.860 in Type Ⅱa hemifacial microsomia, z=-1.50, P=0.134 in Type-Ⅱb hemifacial microsomia). Conclusion:Condylar resorption of the affected side would happen in post mandibular distraction osteogenesis of the hemifacial microsomia patients, and the condylar resorption rate of the affected side has relationship with the elogation distance and affected preoperative condylar height.
9.The morphological changes of temporomandibular joint post L-shaped reduction malarplasty
Kaiyi SHU ; Jiuli ZHAO ; Wei LIU ; Zhiyong ZHANG
Chinese Journal of Plastic Surgery 2022;38(2):196-202
Objective:Analyzing the morphological and functional changes of the temporomandibular joint (TMJ) post L-shaped reduction malarplasty. And evaluating the surgical safety.Methods:The female cosmetic patients who underwent L-shaped reduction malarplasty in the Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from December 2015 to March 2019 were recruited as the study object. Three-dimension models of pre-operation and post-operation were created by the analysis of computed tomography (CT) data via Materialise ProPlan CMF 3.0. Seventeen groups of data relating to the length and angle of the TMJ were measured in the axial plane, coronal plane and sagittal plane. These measurements included condylar anteroposterior diameter in the axial plane and condylar anterior space, superior space and posterior space in the sagittal plane. Data were analyzed via SPSS 22.0 statistical software.Results:Thirty female cosmetic patients who underwent L-shaped reduction malarplasty were included. Patient age ranged from 21 to 36 years and the mean age was (26.19±4.08) years. Fifteen patients were less than 25 years old, and other fifteen patients were more than or at least 25 years old. The condylar anteroposterior diameter post-operation was significantly longer than pre-operation in the axial plane [(9.406±1.241) mm vs.(9.259±1.276) mm], and the difference was (0.146±0.388) mm. The condylar anterior space, superior space and posterior space post-operation were all significantly smaller than pre-operation in the sagittal plane [(1.080±0.537) mm vs.(1.193±0.533) mm/(1.598±0.591) mm vs.(1.907±0.755) mm/(1.239±0.568) mm vs.(1.670±0.926)mm], and the differences were (0.113±0.409) mm, (0.309±0.711) mm, and(0.431±0.786) mm, respectively. Other thirteen measurements showed none significant differences when compared to pre-operation and post-operation ( P>0.05). Conclusions:L-shaped reduction malarplasty could trigger slight morphological changes to the TMJ. However the TMJ could adapt these changes and reach to a new balance due to compensated adaptation. The normal physiological function would not be impacted. Surgery itself could be considered as a safe contour cosmetic surgery.
10.Study of morphological measurement of skull base with hemifacial microsomia in children
Lunkun MA ; Xi XU ; Shanbaga ZHAO ; Kaiyi SHU ; Xiyuan LI ; Yingxiang LIANG ; Shi FENG ; Wei LIU ; Xiaojun TANG ; Lin YIN ; Zhiyong ZHANG
Chinese Journal of Plastic Surgery 2022;38(10):1148-1154
Objective:To investigate the morphological characteristics of skull base in children with hemifacial microsomia (HFM) by three-dimensional reconstruction and measurement of skull base.Methods:Three-dimensional spiral CT data of HFM children with unilateral involvement who had not received any treatment from the First Center of Maxillofacial Plastic Surgery, Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from February 2010 to December 2020 were collected. The patients were divided into four groups according to the Pruzansky-Kaban classification standard: Ⅰ, Ⅱa, Ⅱb and Ⅲ. The three-dimensional reconstruction and measurement of the skull base were performed using Mimics 17.0 software. Linear measurements of the skull base included the distance from tuberculum sellae to optic canal (OT), foramen rotundum (FrT), foramen ovale (FT), internal acoustic meatus (IT), hypoglossal canal (HT), and the distance from anterior clinoid process to the lesser wing of the sphenoid bone (ClS) and the petrous ridge of the temporal bone (ClP). The measurement indexes of skull base angle included anterior cranial angle (ACA), middle cranial angle (MCA), posterior cranial angle (PCA), and petrous ridge angle (PRA). SPSS 26.0 software was used for statistical analysis of the measurement result. Paired t-test was used for comparison within each group, and one-way ANOVA was used for comparison between different types. P<0.05 was statistically significant. Results:A total of 40 children with HFM were collected, with 10 cases in each group. The result of skull base angle measurement showed that the MCA of the healthy side of typeⅠHFM was significantly larger than that of the affected side, and the MCA and PRA of the healthy side of type Ⅲ HFM were larger than those of the affected side ( P<0.05). There was no significant difference in the angle of skull base between the healthy side and the affected side of typeⅡa andⅡb HFM ( P>0.05). In terms of linear distance measurement of skull base, FrT and HT on the healthy side of typeⅠHFM were longer than those on the affected side; FrT, IT, HT and ClP on the healthy side of typeⅡa HFM were significantly longer than those on the affected side; IT, HT and ClP on the healthy side of typeⅡb HFM were longer than those on the affected side; and HT on the healthy side of type Ⅲ HFM was longer than those on the affected side ( P<0.05). The difference between FrT and ClP (affected / healthy) of four types of HFM was statistically significant ( P<0.05). Conclusions:The morphology of HFM is different between the affected side and the healthy side. As for the angle of skull base, MCA was obvious smaller in the affected side than that in the healthy side in the type Ⅰ and type Ⅲ HFM. As for the linear measurement, the distance from the hypoglossal canal to the tuberculum sellae on the affected side is shorter than that on the healthy side in each type HFM, indicating that the growth and development of the cranial base on the affected side is affected in a certain degree.

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