Objective:To evaluate the accuracy of L-shaped reduction malarplasty under the guidance of virtual surgical planning (VSP).Methods:The data of adult female patients who were diagnosed with zygomatic protrusion or hypertrophy at Department of Orthognathic and Temporo-mandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, from January 2018 to December 2020 were analyzed retrospectively. L-shaped reduction malarplasty with or without bone resection and with the mortice and tenon joint structure on the zygomatic arch was conducted either by digital procedures comprising VSP and three-dimensional printing titanium templates (digtal surgery group) or by conventional method (control group). The incidence of postoperative complications and the patient postoperative satisfaction [using a Likert scale with a score ranging from 1 to 5, representing very dissatisfied, dissatisfied, average, satisfied and very satisfied, satisfaction rate = (very satisfied + satisfied)/ total number of patients × 100%] were statistically analyzed in the two groups. The differences in the postoperative symmetry of the zygomatic complex between the digital group and the control group were analyzed by three-dimensional cephalometry. The accuracy of VSP in L-shaped reduction malarplasty was evaluated by comparing the preoperative design model with the actual postoperative model in the digital group. The statistical analyses were conducted using SPSS 24.0 software. The chi-square test was used in the comparison of surgical complications and patient satisfaction rates. The symmetry of bilateral landmarks in the three-dimensional direction between the two groups was evaluated using the independent t-test, and the pre- and post-operative measurements in the digital group were compared using paired t-test. Results:A total of 78 patients were included, with 36 in the digital group, aged (25.2±3.6) years, and 42 in the control group, aged (24.3±2.8) years. Satisfactory reduction of zygomatic protrusion or hypertrophy was recognized among all patients. Compared with the control group, the digital group had lower percentage of complications [25% (9/36) vs. 55% (23/42)] and higher postoperative satisfaction [78% (28/36) vs. 48% (20/42)], both of which were statistically significant (all P<0.01). Regarding the symmetry of bilateral zygomatic complexes, the average deviations of ΔZb (bottom point of zygoma) in the digital group in the horizontal, vertical, and sagittal directions [(1.05±0.24), (1.05±0.24), (1.00±0.88) mm] were significantly smaller than those in the control group [(2.03±0.58), (1.32±0.68), (1.47±0.47) mm], with statistically significant differences (all P<0.05). The bone segment movements of virtual plans and actual result in the digital surgery group were measured and showed no obvious difference for the inward movement [(5.42±0.98) mm vs. (5.33±0.93) mm] and the sagittal overlap [(4.87±1.21) mm vs. (4.77±1.32) mm] at the zygoma roots, along with the step length at the long-arm of the L-shaped osteotomy line [(2.43±1.11) mm vs. (2.39±0.89) mm] (all P>0.05). The mean differences of facial width and protrusion measurements between virtual simulations and actual result in the digital group ranged from (1.13±0.47) mm to (2.07±0.88) mm, with no significant differences( P>0.05). Meanwhile, the high resemblance between virtual plans and actual result was depicted via superimposition models, with a deviation controlled within ±0.5 mm. Conclusion:The application of VSP in reduction malarplasty significantly improved surgical accuracy and reduced difficulties in the operation, which would improve patients’ postoperative satisfaction.

Objective To investigate the effects of Tongyangxiao(TYX)lotion on the healing of infected wounds and the expression of interleukin(IL)-1β and inhibitor of nuclear factor κBα(IκBα)/p65 in rats.Methods Fifty rats were randomly assigned to the model group,potassium permanganate(PP)group,and low-,medium-,and high-dose(TYX-L,TYX-M,TYX-H)groups,with 10 rats in each group.An open infection model of full-thickness skin defects was established,and the rats in each group were treated with the corresponding medicinal solution for dressing changes once a day for a total of 14 days.The wound healing of rats was observed,and immunofluorescence,immunohistochemistry,and Western blotting were used to detect the nuclear translocation rate of p65 and the expression levels of IL-1β,p-IκBα/IκBα,and p-p65/p65 proteins in the granulation tissue.Results Compared with the model group,the wound healing rates of both the TYX-M group and the TYX-H group increased on the 7th day of treatment(P<0.05).Compared with the model group and the PP group,the wound healing rates of the TYX-L group,the TYX-M group and the TYX-H group increased on the 14th day of treatment(P<0.05).On the 7th day of treatment,the expression of IL-1β in the TYX-M group was lower than that in the PP group and the Model group(P<0.05),and the p-IκBα/IκBα ratio in the TYX-H group was lower than that in the PP group and the model group(P<0.05).The nuclear translocation rates of p65 in the TYX-L group,TYX-M group and TYX-H group were lower than those in the PP group and model group(P<0.05).On the 14th day of treatment,the p-p65/p65 ratio in the TYX-H group and the TYX-M group was lower than that in the model group(P<0.05),and the IL-1β in the TYX-L group,the TYX-M group,and the TYX-H group and p-IκBα/IκBα ratio in the TYX-H group were lower than those in the PP group and the model group(P<0.05).Conclusion The mechanism of TYX lotion in promoting the healing of infected wounds was associated with the suppression of the activation of NF-κB signaling pathway and alleviation of inflammatory responses.

Objective To investigate the effects of Tongyangxiao(TYX)lotion on the healing of infected wounds and the expression of interleukin(IL)-1β and inhibitor of nuclear factor κBα(IκBα)/p65 in rats.Methods Fifty rats were randomly assigned to the model group,potassium permanganate(PP)group,and low-,medium-,and high-dose(TYX-L,TYX-M,TYX-H)groups,with 10 rats in each group.An open infection model of full-thickness skin defects was established,and the rats in each group were treated with the corresponding medicinal solution for dressing changes once a day for a total of 14 days.The wound healing of rats was observed,and immunofluorescence,immunohistochemistry,and Western blotting were used to detect the nuclear translocation rate of p65 and the expression levels of IL-1β,p-IκBα/IκBα,and p-p65/p65 proteins in the granulation tissue.Results Compared with the model group,the wound healing rates of both the TYX-M group and the TYX-H group increased on the 7th day of treatment(P<0.05).Compared with the model group and the PP group,the wound healing rates of the TYX-L group,the TYX-M group and the TYX-H group increased on the 14th day of treatment(P<0.05).On the 7th day of treatment,the expression of IL-1β in the TYX-M group was lower than that in the PP group and the Model group(P<0.05),and the p-IκBα/IκBα ratio in the TYX-H group was lower than that in the PP group and the model group(P<0.05).The nuclear translocation rates of p65 in the TYX-L group,TYX-M group and TYX-H group were lower than those in the PP group and model group(P<0.05).On the 14th day of treatment,the p-p65/p65 ratio in the TYX-H group and the TYX-M group was lower than that in the model group(P<0.05),and the IL-1β in the TYX-L group,the TYX-M group,and the TYX-H group and p-IκBα/IκBα ratio in the TYX-H group were lower than those in the PP group and the model group(P<0.05).Conclusion The mechanism of TYX lotion in promoting the healing of infected wounds was associated with the suppression of the activation of NF-κB signaling pathway and alleviation of inflammatory responses.

Objective:To evaluate the accuracy of L-shaped reduction malarplasty under the guidance of virtual surgical planning (VSP).Methods:The data of adult female patients who were diagnosed with zygomatic protrusion or hypertrophy at Department of Orthognathic and Temporo-mandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, from January 2018 to December 2020 were analyzed retrospectively. L-shaped reduction malarplasty with or without bone resection and with the mortice and tenon joint structure on the zygomatic arch was conducted either by digital procedures comprising VSP and three-dimensional printing titanium templates (digtal surgery group) or by conventional method (control group). The incidence of postoperative complications and the patient postoperative satisfaction [using a Likert scale with a score ranging from 1 to 5, representing very dissatisfied, dissatisfied, average, satisfied and very satisfied, satisfaction rate = (very satisfied + satisfied)/ total number of patients × 100%] were statistically analyzed in the two groups. The differences in the postoperative symmetry of the zygomatic complex between the digital group and the control group were analyzed by three-dimensional cephalometry. The accuracy of VSP in L-shaped reduction malarplasty was evaluated by comparing the preoperative design model with the actual postoperative model in the digital group. The statistical analyses were conducted using SPSS 24.0 software. The chi-square test was used in the comparison of surgical complications and patient satisfaction rates. The symmetry of bilateral landmarks in the three-dimensional direction between the two groups was evaluated using the independent t-test, and the pre- and post-operative measurements in the digital group were compared using paired t-test. Results:A total of 78 patients were included, with 36 in the digital group, aged (25.2±3.6) years, and 42 in the control group, aged (24.3±2.8) years. Satisfactory reduction of zygomatic protrusion or hypertrophy was recognized among all patients. Compared with the control group, the digital group had lower percentage of complications [25% (9/36) vs. 55% (23/42)] and higher postoperative satisfaction [78% (28/36) vs. 48% (20/42)], both of which were statistically significant (all P<0.01). Regarding the symmetry of bilateral zygomatic complexes, the average deviations of ΔZb (bottom point of zygoma) in the digital group in the horizontal, vertical, and sagittal directions [(1.05±0.24), (1.05±0.24), (1.00±0.88) mm] were significantly smaller than those in the control group [(2.03±0.58), (1.32±0.68), (1.47±0.47) mm], with statistically significant differences (all P<0.05). The bone segment movements of virtual plans and actual result in the digital surgery group were measured and showed no obvious difference for the inward movement [(5.42±0.98) mm vs. (5.33±0.93) mm] and the sagittal overlap [(4.87±1.21) mm vs. (4.77±1.32) mm] at the zygoma roots, along with the step length at the long-arm of the L-shaped osteotomy line [(2.43±1.11) mm vs. (2.39±0.89) mm] (all P>0.05). The mean differences of facial width and protrusion measurements between virtual simulations and actual result in the digital group ranged from (1.13±0.47) mm to (2.07±0.88) mm, with no significant differences( P>0.05). Meanwhile, the high resemblance between virtual plans and actual result was depicted via superimposition models, with a deviation controlled within ±0.5 mm. Conclusion:The application of VSP in reduction malarplasty significantly improved surgical accuracy and reduced difficulties in the operation, which would improve patients’ postoperative satisfaction.

【Objective】 To evaluate the safety and efficacy of modified ultrasound-guided needle-like visible nephroscope (Needle perc) holmium laser lithotripsy in the treatment of 1-2 cm calyceal calculi, and provide a reference for the selection of clinical treatment methods. 【Methods】 The clinical data of 60 patients with single intrarenal calyceal calculi (the largest diameter 1~2 cm) treated in our hospital during Jan.2022 and May 2023 were retrospectively analyzed.The patients were divided into ureteroscopic holmium laser lithotripsy group (flexible ureteroscope group) and Needle perc group, with 30 patients in either group.The clinical data of the two groups were compared. 【Results】 Compared with the flexible ureteroscope group, the Needle perc group had shorter overall hospitalization time [(3.00±1.25) d vs. (4.00±1.25) d], shorter operation time [(44.63±5.42) min vs. (48.50±7.24) min], lower hospitalization expenses [(15 518±441) yuan vs. (16 872±903) yuan], higher stone-clearance rate [93.3% (28/30) vs. 50.7% (15/30), P<0.001], less increase of procalcitonin after operation [(0.02±0.01) vs. (0.12±0.18), P=0.007], and lower incidence of complications [3.3% (1/30) vs. 26.7% (8/30), P=0.030]. 【Conclusion】 The modified ultrasound-guided Needle perc holmium laser lithotripsy is safe and effective in the treatment of 1-2 cm lower calyceal calculi, with high stone removal rate and low complication rate.

Objective To explore the mechanism of Tongyangxiao Lotion(TYX)for promoting wound healing following surgery for anal fistula.Methods The active ingredients and drug targets of TYX were explored using TCMSP and BATMAN databases,and the targets associated with wound healing were screened using GeneCards and OMIM databases;the intersecting drug and wound-related targets were analyzed with protein-protein interaction(PPI)analysis and GO and KEGG enrichment analyses.In 25 SD rat models with simulated anal fistula surgery,the effect of wound dressing with TYX at low,medium and high doses(once daily for 14 days)on wound healing were assessed in comparison with potassium permanganate(PP)solution.The granulation tissues collected from the wounds were examined for pathological changes with HE staining and for TNF-α expression using immunohistochemistry.The expressions of 1β,TNF-α,IL-6 mRNA and proteins in the granulation tissue were detected using RT-qPCR,Western blotting or ELISA.Results Network pharmacology analysis yielded 156 common targets between TYX and wound healing,and among them IL-1β,TNF-α,and IL-6 were identified as potential targets of TYX for promoting wound healing.Six core components of TYX were capable of binding to IL-1β,TNF-α,and IL-6 with binding energies all below-6.0 Kcal/mol.In the rat models,the wounds with TYX and PP solution dressing showed significantly reduced inflammatory cell infiltration and increased fibroblasts and collagen deposition.TYX at the 3 doses and PP solution all significantly reduced the expressions of IL-6,IL-1β,TNF-α mRNA and IL-6 protein in the granulation tissues,but TYX at the medium and high doses produced significantly stronger effects than PP solution for lowering TNF-α protein expression and mRNA expressions of TNF-α and IL-6.Conclusion TYX accelerates wound healing by down-regulating the inflammatory factors and reducing inflammation in the wounds.

Objective:To evaluate the stability of the zygomatic complex in reduction malarplasty (RM) with different fixation method.Methods:The clinical data of patients with zygomatic arch protrusion at the Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2018 to January 2021 were analyzed retrospectively. All patients underwent L-shaped osteotomy reduction malarplasty which were divided into zygomatic body fixation (ZBF) and zygomatic arch fixation (ZAF) according to fixation technique. As for ZBF, there were 4 different groups including two bicortical screws (2LS), an L-shaped plate with one bicortical screw (LPLS), an L-shaped plate with short-wing on the zygoma (LPwZ) and an L-shaped plate with short-wing on the maxilla (LPwM). As for ZAF, there were 3 different groups including mortice-tenon (MT), 3-hole plate (3HP) and short screw (SS). CT imaging data of two postoperative periods (1 week later; 6 months later) were collected. ITK-SNAP and 3D Slicer software were applied to evaluate the difference in the displacement distance of relevant landmarks of the zygomatic complex, so as to compare the postoperative stability of RM under different fixation methods. Statistical analyses were performed using IBM SPSS Statistics, version 25.0, and Kruskal-Wallis method was used to compare the difference of relevant landmarks displacement distance between ZBF group and ZAF group. P<0.05 was considered statistically significant. Results:60 patients (120 zygomatic arches) who were composed of 21 men and 39 women, aged (27.1±4.9) years were included. There were 30 samples in each group of ZBF and 40 samples in each group of ZAF. Compared with the single L-shaped plate (LPwZ, LPwM) group, the displacement distance of zygomatic complex in 2LS and LPLS groups was shorter ( P<0.05). The three fixation method of zygomatic arch (MT, 3HP, SS) had similar effects on the displacement of zygomatic complex ( P>0.05). Conclusion:After RM, the "two-bridge" fixation method (2LS and LPLS) provides better stability than the single L-shaped plate. The stability of all ZAF is similar when combined with 2LS or LPLS.

Objective:To evaluate the stability of the zygomatic complex in reduction malarplasty (RM) with different fixation method.Methods:The clinical data of patients with zygomatic arch protrusion at the Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2018 to January 2021 were analyzed retrospectively. All patients underwent L-shaped osteotomy reduction malarplasty which were divided into zygomatic body fixation (ZBF) and zygomatic arch fixation (ZAF) according to fixation technique. As for ZBF, there were 4 different groups including two bicortical screws (2LS), an L-shaped plate with one bicortical screw (LPLS), an L-shaped plate with short-wing on the zygoma (LPwZ) and an L-shaped plate with short-wing on the maxilla (LPwM). As for ZAF, there were 3 different groups including mortice-tenon (MT), 3-hole plate (3HP) and short screw (SS). CT imaging data of two postoperative periods (1 week later; 6 months later) were collected. ITK-SNAP and 3D Slicer software were applied to evaluate the difference in the displacement distance of relevant landmarks of the zygomatic complex, so as to compare the postoperative stability of RM under different fixation methods. Statistical analyses were performed using IBM SPSS Statistics, version 25.0, and Kruskal-Wallis method was used to compare the difference of relevant landmarks displacement distance between ZBF group and ZAF group. P<0.05 was considered statistically significant. Results:60 patients (120 zygomatic arches) who were composed of 21 men and 39 women, aged (27.1±4.9) years were included. There were 30 samples in each group of ZBF and 40 samples in each group of ZAF. Compared with the single L-shaped plate (LPwZ, LPwM) group, the displacement distance of zygomatic complex in 2LS and LPLS groups was shorter ( P<0.05). The three fixation method of zygomatic arch (MT, 3HP, SS) had similar effects on the displacement of zygomatic complex ( P>0.05). Conclusion:After RM, the "two-bridge" fixation method (2LS and LPLS) provides better stability than the single L-shaped plate. The stability of all ZAF is similar when combined with 2LS or LPLS.

Objective To explore the mechanism of Tongyangxiao Lotion(TYX)for promoting wound healing following surgery for anal fistula.Methods The active ingredients and drug targets of TYX were explored using TCMSP and BATMAN databases,and the targets associated with wound healing were screened using GeneCards and OMIM databases;the intersecting drug and wound-related targets were analyzed with protein-protein interaction(PPI)analysis and GO and KEGG enrichment analyses.In 25 SD rat models with simulated anal fistula surgery,the effect of wound dressing with TYX at low,medium and high doses(once daily for 14 days)on wound healing were assessed in comparison with potassium permanganate(PP)solution.The granulation tissues collected from the wounds were examined for pathological changes with HE staining and for TNF-α expression using immunohistochemistry.The expressions of 1β,TNF-α,IL-6 mRNA and proteins in the granulation tissue were detected using RT-qPCR,Western blotting or ELISA.Results Network pharmacology analysis yielded 156 common targets between TYX and wound healing,and among them IL-1β,TNF-α,and IL-6 were identified as potential targets of TYX for promoting wound healing.Six core components of TYX were capable of binding to IL-1β,TNF-α,and IL-6 with binding energies all below-6.0 Kcal/mol.In the rat models,the wounds with TYX and PP solution dressing showed significantly reduced inflammatory cell infiltration and increased fibroblasts and collagen deposition.TYX at the 3 doses and PP solution all significantly reduced the expressions of IL-6,IL-1β,TNF-α mRNA and IL-6 protein in the granulation tissues,but TYX at the medium and high doses produced significantly stronger effects than PP solution for lowering TNF-α protein expression and mRNA expressions of TNF-α and IL-6.Conclusion TYX accelerates wound healing by down-regulating the inflammatory factors and reducing inflammation in the wounds.

Objective By assessing the uncertainty of the determination results for the concentration of ambroxol hydrochloride injection,the reliability of the concentration measurement results is improved,ensuring the safety and efficacy of high-risk dosage form medications.Methods The uncertainty assessment of the content determination results by HPLC external standard method was conducted using both the TOP-DOWN method and the GUM method in the past.The TOP-DOWN method evaluated after synthesizing two components:the combined bias uncertainty component and the intermediate precision uncertainty component.The GUM method analyzed six sources of uncertainty based on the experimental process and evaluated after synthesizing the uncertainty.Results When the confidence level was 95％,the expanded uncertainty assessed by the TOP-DOWN method and the GUM method was 1.84％and 2.36％respectively(K=2).Conclusion The results from both assessments indicated that the determination of ambroxol hydrochloride injection content was reliable,ensuring the safety and efficacy of the drug.