Objective To evaluate the clinical efficacy of anterior maxillary segmental distraction osteogenesis and Le Fort Ⅰ Osteot-omy on secondary maxillary hypoplasia in patients with cleft lip and palate.Methods Twenty-five patients with maxillary hypoplasia secondary to cleft lip and palate underwent surgery in maxillofacial surgical department of the Affiliated Stomatological Hospital of Nan-jing Medical University were selected.Ten cases were treated using tooth-borne distractors for anterior maxillary distraction osteogene-sis,and fifteen cases underwent Le Fort Ⅰ Osteotomy.Cone-beam CT,positive and lateral features,speech recording and nasopharyn-geal fibroscope were taken one week before operation and one month after surgery.The clinical outcomes of the two methods and their influence on patients'speech function were measured and compared using t-test.Results Both techniques effectively advanced the maxilla and significantly improved the patients'profiles.Anterior maxillary segmental distraction osteogenesis,which was economical and minimally invasive,greater advanced the maxilla.However,the postoperative profile was better in patients undergoing Le Fort Ⅰ osteotomy,with statistically significant differences(P<0.05).Neither technique significantly affected speech,but Le Fort Ⅰ osteotomy had a greater impact on palatopharyngeal anatomy,indicated by increased soft palate length(2.01±1.71)mm,reduced thickness(0.98±0.50)mm,and increased pharyngeal depth(3.06±1.35)mm,with statistically significant differences(P<0.05).Conclusion Anterior maxillary segmental distraction osteogenesis and orthognathic surgery are both effective methods for the treatment of secondary maxillary hypoplasia in cleft lip and palate patients.Anterior maxillary distraction osteogenesis has advantages over Le Fort I osteotomy in terms of economic benefits and its impact on the soft palate structure.

Objective:To explore the safety and clinical value of ultrasound-guided percutaneous core needle biopsy in the diagnosis of cardiac intermural tumors and pericardial tumors.Methods:Seven patients who underwent ultrasound-guided percutaneous cardiac tumors needle biopsy in Fujian Provincial Hospital from January 2012 to December 2019 were selected for this study. The locations and sizes of the lesions were recorded preoperatively by echocardiography and the operation time was recorded by conventional ultrasonography. The postoperative complications was followed up, and the satisfaction of pathological materials was used as the evaluation standard to comprehensively analyze the safety and clinical application value of ultrasound-guided percutaneous biopsy in the diagnosis of cardiac tumors.Results:Ultrasound-guided percutaneous biopsy was performed successfully in all the 7 cases, 3 of them were intermural tumors and 4 of them were pericardial tumors. Except for 2 patients with diffuse pericardial space, the maximum diameter of the remaining 5 patients was (58.6±23.5)mm. Six cases were punctured from the apex of the heart, and 1 case from the left parasternal through third intercostal space toward the bottom of the heart as the needle pathway. The satisfaction of pathological material was 100%, and the time of procedure was (15.1±3.3)min. There were no postoperative complications such as bleeding, infection or arrhythmia.Conclusions:Ultrasound-guided percutaneous transthoracic needle biopsy is safe and feasible, which provides a simple and easy method for the biopsy of cardiac intramural tumors and pericardial tumors.

Objective To observe the clinical efficacy of acupoint sticking with Chan Wu gel in managing cancer pain.Method A hundred patients were randomized into a treatment group of 50 cases and a control group of 50 cases. The treatment group was intervened by thethree-step analgesic ladder plus acupoint sticking with Chan Wu gel; the control group was by the three-step analgesic ladder alone. The decrease of the pain degree, action and lasting time of analgesia, and adverse reactions in the two groups were observed.Result The treatment group was superior to the control group in comparing the release of pain, action and lasting time of analgesia; the occurrence rate of adverse reactions in the treatment group was obviously lower than that in the control group(P<0.05).Conclusion The conventional three-step analgesic ladder plus acupoint sticking with Chan Wu gel is effective in mitigating cancer pain, and it can reduce the dose of the three-step analgesics and the adverse reactions.

Objective To investigate the role of Th17/Treg balance in immune mechanism in severe exacerbation of hepatitis B.Methods The clinical data of 41 patients with chronic hepatitis B were collected,and according to the conditions during hospitalization,these patients were divided into exacerbation group (19 patients) and improvement group (22 patients).On admission,at weeks 1 and 2 of treatment,and at the end of treatment,flow cytometry was used to measure the frequencies of Th 17 and Treg cells in peripheral blood,and enzyme-linked immunosorbent assay was used to determine the serum levels of interleukin-17 (IL-17),interleukin-10 (IL-10),and transforming growth factor-β (TGF-β).The dynamic changes in the frequencies of Th17 and Treg cells were compared between the two groups,and the correlation between clinical indices for hepatitis and cytokines was analyzed.The t-test was used for comparison between groups,a one-way analysis of variance was used for comparison within one group across different time points,and Pearson correlation analysis was performed.Results With disease progression,the exacerbation group showed an increase in the frequency of Th 17 cells and a relatively low frequency of Treg cells;compared with the improvement group,the exacerbation group had a higher frequency of Th 17 cells and a lower frequency of Treg cells.Th1 7/Treg ratio gradually increased with exacerbation and decreased with improvement in conditions;in the exacerbation group and the improvement group,Th17/Treg ratio was positively correlated with total bilirubin and negatively correlated with prothrombin activity.In the exacerbation group and the improvement group,Th 17 cells were positively correlated with IL-17,and Treg cells were positively correlated with IL-10 and TGF-β.Conclusion Th1 7 and Treg cells play important roles in severe exacerbation of hepatitis B,and Th1 7/Treg ratio may be used as an immunobiological marker for the judgment of severity during severe exacerbation of hepatitis B.

Objective To discuss the relationship between echogenicity and fat content in renal tumor.Methods 52 renal tumors were examined with preoperative ultrasonography,all tumors were 3 cm in diameter or less.The tumor echogenicity was classified as echogenicity increasement type (including hyperechoic and slightly hyperechoic) and echogenicity decreasement type (hypoechoic).The relationship between echogenicity and adipose staining in tumor were analyzed.Results In 18 cases pathologically proved benign renal tumor,14(77.8 ％) of the tumors were hyperechoic and were angiomyolipoma(AMLs),4(22.2％) of the tumors were hypoechoic including 2 poor fat AMLs and 2 rare benign tumors,slightly hyperechoic case was not detected.In 34 cases malignant renal tumors,27(79.4％) of the tumors were slightly hyperechoic including 22 clear cell renal cell carcinomas (RCCAs) and 5 papillary RCCAs,7 (20.6％) of the tumors were hypoechoic including 2 clear cell RCCAs,3 papillary RCCAs and 2 chromophobe RCCAs.Hyperechoic case was not detected.The adipose staining of 41 cases of echogenicity increasement type was all positive,in the 11 cases of echogenicity decreasement type,9 tumors were adipose staining negative,while the other 2 tumors were positive,and there were statistically significant between two groups (P ＜0.05).Conclusions Echogenicity was obviously correlate with fat content in renal tumor.Tumors containing rich fat appear to be increased in echogenicity,tumors without fat content appear to be decreased in echogenicity.