Objective:To investigate a new method for the reconstruction of hemifacial microsomia by sagittal osteotomy of the affected mandibular outer cortex combined with bone graft of mandibular outer cortex from healthy side.Methods:From March 2006 to March 2023, the clinical data of patients with hemifacial microsomia admitted to the Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. Preoperative diagnosis and surgical design were performed based on clinical manifestations and imaging findings. All cases were operated under general anesthesia. The affected mandibular outer cortex was previously split by an intraoral approach, and then the mandibular outer cortex of appropriate shape and size on the healthy side was harvested and grafted into the split bone space according to the preoperative design, following by internal rigid fixation. Complications, facial appearance improvement, and patient satisfaction were followed up. Photographs were taken preoperative, immediately postoperative and at the long-term(last) postoperative follow-up, and the severity of the deformity was analyzed. CT data from preoperative, immediate postoperative, and long-term follow-up visits were imported into Surgicase Proplan medical three-dimensional image workstation in Dicom format. The mandible was reconstructed using Segmentation, and the thickness of the mandible was measured during pre-operative, immediate post-operative and long-term follow-up visits. Anova with repeated measurement design was used to compare measurements and LSD test was used for multiple comparisons. The Kruskal-Wallis rank sum test were used to statistically analyze malformation severity. P< 0.05 is considered statistically significant. Results:A total of 39 patients were included in this study, including 13 females and 26 males, with an average age of (22.21±4.57) years (15-27 years). All patients were followed up for an average of (45.56±39.41) months (6-153 months) after surgery. The grafted mandibular outer cortex grows well with the adjacent bone tissue, and the mandibular angle and mandibular body are significantly wider. Of the 39 cases, 1 developed an infection 1 year after surgery, the titanium plate was exposed, and the patient healed after debridement and removal of the immobilizing splint. The facial appearance of the other patients improved significantly. Preoperative, immediate postoperative and long term follow up of mandibular thickness measurements were compared in pairs, and the differences were statistically significant (all P<0.05). The patient’s appearance satisfaction score: the preoperative score was [2.0(1.5, 2.0)] points, the immediate postoperative score was [4.0(4.0, 4.0)] points, the score of the last postoperative follow up was [4.0(4.0, 4.0)] points. There was statistical difference in satisfaction among the three groups ( P<0.01). The preoperative scores were compared with the scores of the immediate postoperative and the last postoperative follow-up respectively, and the differences were statistically significant( P<0.01). There was no statistical significance in satisfaction between the immediate postoperative score and the score of the last postoperative follow up ( P>0.05). Conclusion:The sagittal splitting osteotomy of the mandibular outer cortex is consistent with the features of mandibular anatomy, and provides a good condition for the grafting and healing of autogenous bone. Removing the outer cortex of the mandible on the healthy side not only increases the thickness of the affected side, but also decreases the width of the angle of the mandible on the healthy side, so as to effectively correct the asymmetric deformity of the mandible. The method is simple, with few complications and good results, and is one of the ideal treatments to correct hemofacial microsomia.

Objective:To investigate a new method for the reconstruction of hemifacial microsomia by sagittal osteotomy of the affected mandibular outer cortex combined with bone graft of mandibular outer cortex from healthy side.Methods:From March 2006 to March 2023, the clinical data of patients with hemifacial microsomia admitted to the Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. Preoperative diagnosis and surgical design were performed based on clinical manifestations and imaging findings. All cases were operated under general anesthesia. The affected mandibular outer cortex was previously split by an intraoral approach, and then the mandibular outer cortex of appropriate shape and size on the healthy side was harvested and grafted into the split bone space according to the preoperative design, following by internal rigid fixation. Complications, facial appearance improvement, and patient satisfaction were followed up. Photographs were taken preoperative, immediately postoperative and at the long-term(last) postoperative follow-up, and the severity of the deformity was analyzed. CT data from preoperative, immediate postoperative, and long-term follow-up visits were imported into Surgicase Proplan medical three-dimensional image workstation in Dicom format. The mandible was reconstructed using Segmentation, and the thickness of the mandible was measured during pre-operative, immediate post-operative and long-term follow-up visits. Anova with repeated measurement design was used to compare measurements and LSD test was used for multiple comparisons. The Kruskal-Wallis rank sum test were used to statistically analyze malformation severity. P< 0.05 is considered statistically significant. Results:A total of 39 patients were included in this study, including 13 females and 26 males, with an average age of (22.21±4.57) years (15-27 years). All patients were followed up for an average of (45.56±39.41) months (6-153 months) after surgery. The grafted mandibular outer cortex grows well with the adjacent bone tissue, and the mandibular angle and mandibular body are significantly wider. Of the 39 cases, 1 developed an infection 1 year after surgery, the titanium plate was exposed, and the patient healed after debridement and removal of the immobilizing splint. The facial appearance of the other patients improved significantly. Preoperative, immediate postoperative and long term follow up of mandibular thickness measurements were compared in pairs, and the differences were statistically significant (all P<0.05). The patient’s appearance satisfaction score: the preoperative score was [2.0(1.5, 2.0)] points, the immediate postoperative score was [4.0(4.0, 4.0)] points, the score of the last postoperative follow up was [4.0(4.0, 4.0)] points. There was statistical difference in satisfaction among the three groups ( P<0.01). The preoperative scores were compared with the scores of the immediate postoperative and the last postoperative follow-up respectively, and the differences were statistically significant( P<0.01). There was no statistical significance in satisfaction between the immediate postoperative score and the score of the last postoperative follow up ( P>0.05). Conclusion:The sagittal splitting osteotomy of the mandibular outer cortex is consistent with the features of mandibular anatomy, and provides a good condition for the grafting and healing of autogenous bone. Removing the outer cortex of the mandible on the healthy side not only increases the thickness of the affected side, but also decreases the width of the angle of the mandible on the healthy side, so as to effectively correct the asymmetric deformity of the mandible. The method is simple, with few complications and good results, and is one of the ideal treatments to correct hemofacial microsomia.

OBJECTIVE: To preliminarily verify the effectiveness of self-designed artificial condyle-mandibular distraction (AC-MD) complex in the treatment of Pruzansky type ⅡB and Ⅲ hemifacial microsomia (HFM) through model test. METHODS: Five children with Pruzansky type ⅡB and Ⅲ HFM who were treated with mandibular distraction osteogenesis (MDO) between December 2016 and December 2021 were selected as the subjects. There were 3 boys and 2 girls wih an average age of 8.4 years (range, 6-10 years). Virtual surgery and model test of AC-MD complex were performed according to preoperative skull CT of children. The model was obtained by three-dimensional (3D) printing according to the children's CT data at a ratio of 1∶1. The occlusal guide plate was designed and 3D printed according to the children's toothpaste model. The results of the model test and the virtual surgery were matched in three dimensions to calculate the error of the residual condyle on the affected side, and the model test was matched with the actual skull CT after MDO to measure and compare the inclination rotation of the mandible, the distance between the condylar of the healthy side and the residual condyle of the affected side, and the lengthening length of the mandible. RESULTS: The error of residual condyle was (1.07±0.78) mm. The inclination rotation of the mandible, the distance between the condylar of the healthy side and the residual condyle of the affected side, and the lengthening length of the mandible after 3D printing model test were significantly larger than those after MDO ( P<0.05). CONCLUSION In the model test, the implantation of AC-MD complex can immediately rotate the mandible to the horizontal position and improve facial symmetry, and the residual condyle segment can be guided close to the articular fossa or the preset pseudoarticular position of the skull base after operation.
Male ; Child ; Female ; Humans ; Goldenhar Syndrome/surgery* ; Mandible/surgery* ; Osteogenesis, Distraction/methods* ; Printing, Three-Dimensional ; Facial Asymmetry/surgery*

Objective: To measure the body mass index (BMI) of secondary school students and analyze its association with the physical fitness index, so as to improve the physical health of middle school students. Methods: Using a randomized cluster stratified sampling method, 3 813 secondary school students from six cities (Ganzhou, Ji an, Fuzhou, Nanchang, Shangrao and Jiujiang) in Jiangxi Province, China, were selected in September 2022. Questionnaire survey was administered to obtain basic information and to assess the nutritional status and physical fitness tests were conducted among secondary school students. The study was stratified by gender and age, and the Kruskal Wallis H test was used to compare the differences in the mean values of grip strength, sit-ups, standing long jump performance and strength quality among secondary school students with different BMI levels, while the correlation between BMI and strength quality index was inferred by using curve regression analysis. Results: There was statistical significance in the strength quality index of middle school students with different BMI level ( H=56.79, 8.84, P <0.05). Except 13 years old group, the difference of physical fitness by BMI grade strength quality index of boys in other age groups was statistically significant ( H =22.21, 16.23, 17.98, 18.21, 8.08), while the difference of physical fitness by BMI of girls at 14 years old was statistically significant ( H =9.11)( P <0.05). The curve fitting using regression showed that the physical fitness index and BMI of middle school students (boys and girls) show an inverted U-shaped curve. The physical fitness index was higher in the middle region of BMI ( Z-score) and lower in the two end regions, while showing a decreasing trend from the middle to the two ends. Conclusion An association is found between BMI and physical fitness among secondary school students in Jiangxi Province, and wasting and overweight/obesity are negatively correlated with physical fitness. Greater attention should be paid to the nutritional status of secondary school students to ensure the normal development of physical fitness.

Objective:To investigate the correlation between the SUV index (SUV max of the lesion/SUV mean of the liver) in 18F-FDG PET/CT imaging and the invasiveness of early lung adenocarcinoma presenting as ground-glass nodule (GGN). Methods:From January 2012 to March 2020, 167 GGN patients (49 males, 118 females; age: (61.5±9.0) years) with early lung adenocarcinoma who underwent PET/CT imaging in Changzhou First People′s Hospital were retrospectively enrolled. The image parameters including the GGN number, location, type, edge, shape, abnormal bronchus sign, vacuole sign, pleural depression, vessel convergence sign, GGN diameter ( DGGN), solid component diameter ( Dsolid), consolidation to tumor ratio (CTR, Dsolid/ DGGN), CT values (CT value of ground-glass opacity (CT GGO), CT value of lung parenchyma (CT LP), ΔCT GGO-LP (CT GGO-CT LP)) and SUV index were analyzed. Single and multivariate logistic regressions were used to analyze the correlation between SUV index and infiltration. The generalized additive model was used for curve fitting, and the piece-wise regression model was used to further explain the nonlinearity. Results:In 189 GGNs, invasive adenocarcinoma accounted for 85.2% (161/189). Single logistic regression showed that the GGN number, type, shape, edge, abnormal bronchus sign, pleural depression, vessel convergence sign, DGGN, Dsolid, CTR, CT GGO, ΔCT GGO-LP and SUV index were related factors of infiltration (odds ratio ( OR) values: 0.396-224.083, P<0.001 or P<0.05). After fully adjusting for confounding factors, SUV index was significantly correlated with increased risk of invasion ( OR=2.162 (95% CI: 1.191-3.923), P=0.011). Curve fitting showed that the SUV index was non-linearly related to the risk of infiltration, and the risk of infiltration increased significantly only when the SUV index was greater than 0.43 ( OR=3.509 (95% CI: 1.429-8.620), P=0.006). The correlation between SUV index and infiltration had no interaction between age, vacuoles, pleural depression and CTR subgroups (all P>0.05). Conclusions:SUV index is an independent factor related to the invasiveness of early lung adenocarcinoma. The higher the SUV index, the greater the risk of invasion; but the two are not simply linearly correlated.

Long non-coding RNA (lncRNA) refers to non-coding RNA longer than 200 nt, with one or more short open reading frames (sORF), which encode functional micro-peptides. These functional micro-peptides often play key roles in various biological processes, such as Ca²⁺ transport, mitochondrial metabolism, myocyte fusion, cellular senescence and others. At the same time, these biological processes play a key role in the regulation of body homeostasis, diseases and cancers development and progression, embryonic development and other important physiological processes. Therefore, studying the potential regulatory mechanisms of micro-peptides encoded by lncRNA in organisms will help to further elucidate the potential regulatory processes in organisms. Furthermore, it will provide a new theoretical basis for the subsequent targeted treatment of diseases and improvement of animal growth performance. This review summarizes the latest research progress in the field of lncRNA-encoded micro-peptides, as well as the progress in the fields of muscle physiological regulation, inflammation and immunity, common human cancers, and embryonic development. Finally, the challenges of lncRNA-encoded micro-peptides are briefly described, with the aim to facilitate subsequent in-depth research on micro-peptides.
Animals ; Humans ; Neoplasms/therapy* ; Open Reading Frames ; Peptides/chemistry* ; RNA, Long Noncoding/genetics*

Objective:To investigate the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT metabolic parameters for occult lymph node metastasis (OLM) in non-small cell lung cancer (NSCLC). Methods:A total of 183 patients (72 males, 111 females; age (61.5±8.4) years) who underwent 18F-FDG PET/CT and preoperatively diagnosed with clinical N0 stage (cN0) in Third Affiliated Hospital of Soochow University from January 2013 to December 2018 were retrospectively enrolled. All patients underwent anatomical pulmonary resection with systematic lymph node dissections within 3 weeks after 18F-FDG PET/CT examinations. According to the presence or absence of lymph node metastasis, patients were divided into OLM positive (OLM+ ) group and OLM negative (OLM-) group. Parameters of primary lesions, such as the maximum diameter (D max), tumor sites, morphological features, maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), metabolic total volume (MTV), total lesion glycolysis (TLG), tumor SUV max to liver SUV mean (TLR max), tumor TLG to liver SUV mean (TLR TLG) were analyzed. Mann-Whitney U test and χ2 test were used to compare the parameters between groups. Multivariable logistic regression was used to analyze the independent risk factors for OLM. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different parameters. Results:Among 183 patients, 25 (13.7%, 25/183) of them were diagnosed as OLM. In OLM+ group, 46 lymph nodes were pathologically positive for metastasis, including 15 N1 disease and 31 N2 disease. D max (2.9(2.3, 3.7) vs 2.3(1.7, 2.8) cm), lobulation ((76.0%(19/25) vs 37.3%(59/158)), SUV max (11.1(7.9, 17.7) vs 4.7(2.3, 9.2)), TLG (41.5(10.2, 91.1) vs 15.6(6.5, 23.8) ml), TLR max (4.7(3.5, 7.6) vs 2.1(0.9, 4.0)) and TLR TLG (18.1(5.0, 44.3) vs 6.1(3.0, 11.4) ml) of the primary lesions in OLM+ group were significantly higher than those in OLM-group ( z values: from -4.709 to -3.247, χ2=13.190, all P<0.05). Multivariable logistic regression analysis showed that TLR max (odds ratio ( OR)=15.145, 95% CI: 3.381-67.830, P<0.001) and D max ( OR=3.220, 95% CI: 1.192-8.701, P=0.021) were independent risk factors for OLM. TLR max yielded the highest area under curve (AUC; AUC=0.794) with the threshold of 3.12, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value for predicting OLM were 92.0%(23/25), 63.3%(100/158), 67.2%(123/183), 28.4%(23/81) and 98.0%(100/102), respectively. Conclusions:TLR max of tumor is the independent risk factor for OLM in NSCLC patients. TLR max can sensitively predict OLM preoperatively in patients with NSCLC.

Objective:To investigate the efficacy and safety of superciliary arch augmentation with silicone implant in the treatment of upper facial flatness.Methods:From July 2018 to September 2019, 42 cases aged from 20-32 (25.1±3.1) years old underwent superciliary arch augmentation with silicone implant. According to the anatomical characteristics of supraorbital margin and superciliary arch, A 7 mm surgical incision at the lower edge of the bilateral eyebrow tail was designed. The space was dissected close to the surface of superciliary arch bone and the carved silicone implant in accordance with the shape of the space was implanted. The effective part of the silicone implant was the lower edge, with a thickness of 2-7 mm. The middle part of of the silicone implant was the uppermost, corresponding to the inner third of the eyebrow. Each side of the implant had a small hole to allow tissues to grow in. The silicone implant at the eyebrow tail was sutured and fixed to the periosteum, and the vaseline gauze was packaged and sutured for external fixation at the eyebrow head. Photographs were taken and analyzed preoperatively, immediately after surgery, and at 6-18 months follow-up after surgery. Postoperative satisfaction was scored by patients, surgeons and laypersons according to the Likert 5 scale. SPSS Statistics 21.0 was used for statistical analysis using the Kruskal-Wallis rank sum test, and P < 0.05 was considered to be statistically significant. Results:42 cases were followed up from 6 to 18 (9.0±3.2) months. 1case developed aseptic inflammation 6 months after surgery, and the implant was removed. Four cases were not satisfied with the facial contour and underwent revision surgery. 1 patient developed hematoma, which was absorbed 2 weeks after surgery. The other cases were all satisfied with the results, which were significantly improved compared with the preoperative profiles. The superciliary arch and the upper facial contour were more three-dimensionally defined and the face was more harmonious during the follow-up. All cases had normal expression. No capsular contracture, wound dehiscence and nerve injury occurred. The thickness of the implant (lower edge) was 2-7 mm[(4.53±0.77) mm]. Postoperative satisfaction score: the patient was 2.5-5.0 points, median 4.60(4.38, 4.85)points, doctors was 4.2-5.0 points, mean 4.85(4.70, 4.90)points, third-party was 3.7-5.0 points, median 4.80(4.66, 4.90)points. There was statistical difference in satisfaction rate among the three groups ( H=9.978, P=0.007). There was statistical difference in satisfaction between patients and surgeons ( H=9.978, P=0.009), patients and third-party ( H=9.978, P=0.049). There was no statistical significance in satisfaction between surgeons and third-party ( H=9.978, P=1.000). Conclusions:The superciliary arch augmentation can effectively reshape the facial contour, providing a more refined and three-dimensional face contour. Silicone implant can reliably enhance the superciliary arch and is the first choice for the superciliary arch augmentation. Full understanding of patients’ request, individualized surgery designare the keys to achieve satisfactory results of silicone implant superciliary arch augmentation.

Objective:To investigate the efficacy and safety of superciliary arch augmentation with silicone implant in the treatment of upper facial flatness.Methods:From July 2018 to September 2019, 42 cases aged from 20-32 (25.1±3.1) years old underwent superciliary arch augmentation with silicone implant. According to the anatomical characteristics of supraorbital margin and superciliary arch, A 7 mm surgical incision at the lower edge of the bilateral eyebrow tail was designed. The space was dissected close to the surface of superciliary arch bone and the carved silicone implant in accordance with the shape of the space was implanted. The effective part of the silicone implant was the lower edge, with a thickness of 2-7 mm. The middle part of of the silicone implant was the uppermost, corresponding to the inner third of the eyebrow. Each side of the implant had a small hole to allow tissues to grow in. The silicone implant at the eyebrow tail was sutured and fixed to the periosteum, and the vaseline gauze was packaged and sutured for external fixation at the eyebrow head. Photographs were taken and analyzed preoperatively, immediately after surgery, and at 6-18 months follow-up after surgery. Postoperative satisfaction was scored by patients, surgeons and laypersons according to the Likert 5 scale. SPSS Statistics 21.0 was used for statistical analysis using the Kruskal-Wallis rank sum test, and P < 0.05 was considered to be statistically significant. Results:42 cases were followed up from 6 to 18 (9.0±3.2) months. 1case developed aseptic inflammation 6 months after surgery, and the implant was removed. Four cases were not satisfied with the facial contour and underwent revision surgery. 1 patient developed hematoma, which was absorbed 2 weeks after surgery. The other cases were all satisfied with the results, which were significantly improved compared with the preoperative profiles. The superciliary arch and the upper facial contour were more three-dimensionally defined and the face was more harmonious during the follow-up. All cases had normal expression. No capsular contracture, wound dehiscence and nerve injury occurred. The thickness of the implant (lower edge) was 2-7 mm[(4.53±0.77) mm]. Postoperative satisfaction score: the patient was 2.5-5.0 points, median 4.60(4.38, 4.85)points, doctors was 4.2-5.0 points, mean 4.85(4.70, 4.90)points, third-party was 3.7-5.0 points, median 4.80(4.66, 4.90)points. There was statistical difference in satisfaction rate among the three groups ( H=9.978, P=0.007). There was statistical difference in satisfaction between patients and surgeons ( H=9.978, P=0.009), patients and third-party ( H=9.978, P=0.049). There was no statistical significance in satisfaction between surgeons and third-party ( H=9.978, P=1.000). Conclusions:The superciliary arch augmentation can effectively reshape the facial contour, providing a more refined and three-dimensional face contour. Silicone implant can reliably enhance the superciliary arch and is the first choice for the superciliary arch augmentation. Full understanding of patients’ request, individualized surgery designare the keys to achieve satisfactory results of silicone implant superciliary arch augmentation.

Objective:To explore the value of 18F-deoxyglucose (FDG) PET and high resolution CT (HRCT) combined prediction model in the identification of invasiveness of early lung adenocarcinoma with consolidation-to-tumor ratio (CTR)≤0.5. Methods:A retrospective analysis was performed on 91 patients with early lung adenocarcinoma with CTR≤0.5 who underwent PET/CT and HRCT before surgery in the Third Affiliated Hospital of Soochow University from October 2011 to October 2019, including 110 ground-glass nodules (GGNs). According to the pathological subtypes, they were divided into preinvasive-minimally invasive adenocarcinoma (MIA) group ( n=22) and invasive adenocarcinoma (IAC) group ( n=88). The image feature parameters of GGNs of the two groups were compared, and the HRCT model and PET-HRCT combined model were constructed using Logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was used to compare the diagnostic efficacy of different models. The Bootstrap resampling (times = 500) method was used for internal verification of the model, and we also performed interaction and hierarchical analysis on the model. Results:The proportions of mixed GGN, irregular shape, lobulation sign, dilated/distorted/cutoff bronchial sign, pleural indentation and vascular convergence in IAC group were significantly higher than those in preinvasive-MIA group (all P<0.05). Nodule diameter, solid component diameter, solid component ratio, CT value of ground glass attenuation component (CT GGO), and SUVindex of the IAC group were larger than those of the preinvasive-MIA group, and the differences were statistically significant ( P<0.001). Among the quantitative parameters of HRCT, CT GGO had the best diagnostic efficacy (AUC=0.775), with a sensitivity of 0.580 and a specificity of 0.909. The diagnostic efficacy of HRCT model and PET-HRCT combined model were better than CT GGO (AUC: 0.907 vs. 0.775, 0.931 vs. 0.775; P=0.027, 0.002, respectively), but the diagnostic efficacy of the former two was not statistically different ( P=0.210).When the specificity was 0.909, the sensitivity of the HRCT model and the PET-HRCT model (0.784 and 0.875, respectively) were significantly higher than that of the CT GGO (0.580), and the combined PET-HRCT model had a more significant increase in sensitivity. The PET-HRCT combined model showed no significant interaction between different nodule types, between groups with or without pleural indentation, and among nodule diameter subgroups (all P>0.05). Conclusion:PET-HRCT combined model has a good predictive value for the invasiveness of early lung adenocarcinoma with CTR≤0.5, and it can be used for GGN risk stratification to guide clinical decision-making.