We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

Objective:To explore the predictors of recovery of normal left ventricular ejection fraction (LVEF) in patients with chronic Keshan disease (CKD) after standard anti-heart failure treatment.Methods:From June 2013 to October 2017, CKD patients were selected as the research subjects in 8 Keshan disease counties (cities) in Shandong Province. Demographic data and clinical indicators related to the recovery of normal LVEF were collected at the initial diagnosis, and the patients were given standard anti-heart failure treatment. Follow-up was carried out until October 2019 or until all-cause death. Patients were divided into recovery group and non-recovery group according to whether LVEF returned to normal (LVEF≥50% was normal) by group design, and multi-factor logistic regression was used to analyze the predictors of recovery of normal LVEF.Results:A total of 98 CKD patients were included in this study, their average age was (47.51 ± 12.84) years old; body mass index (BMI) was (23.18 ± 4.92) kg/m 2; LVEF was (39.54 ± 8.26)%; male accounted for 65.31% (64/98); the New York Heart Association (NYHA) heart function grade Ⅱ and grade Ⅲ accounted for 46.94% (46/98) and 53.06% (52/98), respectively. The median follow-up time was 26 months, the LVEF of 28 patients (28.57%) returned to normal, and the LVEF increased from (43.27 ± 7.85)% of the baseline to (58.74 ± 6.07)%, the difference was statistically significant ( t=8.25, P < 0.01); LVEF did not return to normal in 70 patients (71.43%), and the LVEF increased from (37.84 ± 6.93)% of the baseline to (42.94 ± 7.31)%, the difference was statistically significant ( t=4.24, P < 0.01). The median recovery time of 28 patients with normal LVEF recovery was 14 months, of which 4 patients (14.29%), 6 patients (21.43%) and 15 patients (53.57%) recovered at follow-up of 6, 12 and 18 months, respectively, and 27 patients (96.43%) recovered within 3 years. The results of multivariate logistic regression analysis showed that disease course [odds ratio ( OR)=0.81, 95% confidence interval ( CI): 0.70-0.95, P < 0.05], electrocardiogram QRS wave duration ( OR=0.88, 95% CI: 0.79-0.98, P < 0.05), LVEF ( OR=1.26, 95% CI: 1.13-1.42, P < 0.01), and left ventricular end-diastolic diameter (LVEDD, OR=0.79, 95% CI: 0.66-0.90, P < 0.01) were independent predictors of recovery of normal LVEF. Conclusions:LVEF can return to normal after anti-heart failure treatment in some CKD patients. Patients with shorter disease course, shorter electrocardiogram QRS wave duration, higher baseline LVEF and lower LVEDD are more likely to recover from LVEF.

Objective: To realize the efficient monitoring of frequency of medical exposure and dose monitoring in Ningbo by means of informatization. Methods: Data transmission process and the key elements of frequency of medical exposure and individual dose were investigated. According to standardization principles of data elements, the standardized data elements for frequency of medical exposure and individual dose were determined. On this basis, modules and functions of data receiving platform on the frequency of medical exposure and individual dose in Ningbo were designed. Results: Totally 59 data elements on frequency of medical exposure and individual dose were formed. According to their functions, the data receiving platform was divided into the distribution of radiodiagnosis and radiotherapy resources, the frequency monitoring of medical exposure and dose monitoring for permanent residents, and the dose monitoring. Conclusions The establishment of frequency and dose information monitoring platform on medical exposure in Ningbo and the determination of standardized data elements will be conducive to further progress in medical exposure information monitoring in Ningbo.

OBJECTIVE: This study aimed to investigate the application of an osteotomy template and a repositioning template manufactured by three-dimensional (3D) printing technique in maxillary LeFortⅠosteotomy. METHODS: The patient group consisted of eight patients with maxillary hypoplasia who underwent LeFortⅠosteotomy. The mean age at the time of surgery was 25.6 years old. All patients were scanned using cone beam computed tomography (CBCT) to create a 3D model of the maxillary. The osteotomy and repositioning templates of the LeFortⅠosteotomy were manufactured by 3D printing technique. All bones were cut by the same doctor with extensive orthognathic surgery experience. One part of the template guided the osteotomy, and the other repositioned the maxilla during operation. Postoperative CBCT scan was performed, and the virtual plan was compared with the postoperative surgical result using an image fusion of the CBCT dataset by analyzing measurements between six landmarks relative to three reference planes. Statistical analysis was performed, and accuracy was reported using SPSS 16.0 software package. RESULTS: Primary healing of incisions was observed in all patients, and no serious complications were observed. The maximum mean values were 1.35 mm, and the displacement error was UL6 to the coronal plane. The maximum standard deviation was 0.85, and the maximum standard error was 0.30, which was acceptable by clinical standards. CONCLUSIONS The application of osteotomy and repositioning templates manufactured by 3D printing technique in maxillary LeFortⅠosteotomy was safe and can enable doctors to complete a surgery accurately.
Adult ; Cone-Beam Computed Tomography ; Humans ; Imaging, Three-Dimensional ; Maxilla ; Orthognathic Surgical Procedures ; Printing, Three-Dimensional

OBJECTIVEThis research aimed to analyze the three-dimensional position of mandibular canal (MC) and man of MC and its relationship with the surrounding structures dibular morphology of normal young males and females by using data from cone beam computed tomography (CBCT), as well as to provide an anatomical basis for clinical surgery of the mandible.

METHODSNormal occlusion and CBCT scans of 29 normal young people were conducted. InVivo 5 software was used to reconstruct the mandible, anchor the points, and measure the jaw shape and three-dimensional course of MC. All measurements were analyzed with SSPS 17.0 software.

RESULTSThe MC lingual bone cortex was thinner than the MC buccal bone cortex, and the distance of the MC to the buccal bone cortex gradually increased. However, the distance of the MC to the tongue bone cortex and alveolar crest gradually decreased from proximal to distal. In addition, the distance of the MC to the mandibular lower margin was minimal at the first molar and reached the maximum at the second premolar. No significant difference was observed among the heights, widths, and thicknesses of the left and right sides of the cortical bone of the mandibular body cross sections. From the midline to the farthest point, the height and lower one-third thickness of the lingual cortical bone of the mandibular body cross sections gradually decreased, whereas the width of the upper cross section and upper one-third thickness of the buccal cortical bone gradually increased. Significant difference was observed in some measured values.

CONCLUSIONAfter MC enter into the mandibular foramen, it moved away from the lingual to the buccal bone but gradually returned to the lingual bone; its general course is closer to the lingual bone. The mandibles of males are thicker than those of females. CBCT can accurately display the course of MC and its relationship with the surrounding structures.

Alveolar Process ; Bicuspid ; Cone-Beam Computed Tomography ; methods ; Dental Pulp Cavity ; Female ; Humans ; Hyoid Bone ; Male ; Mandible ; anatomy & histology ; diagnostic imaging ; Molar ; Software ; Surveys and Questionnaires ; Tongue ; Zygoma

OBJECTIVETo investigate the application of osteotomy template manufactured via 3D printing technique in bilateral sagittal split osteotomy (BSSO).

METHODSThe patient group consisted of 32 patients (17 males and 15 females) with mandibular hypoplasia who underwent a BSSO setback (Hunsuck modification; 64 splits). The mean age at the time of surgery was 23.5 years (range 1.9-35 years). All patients were scanned using cone beam computed tomography (CBCT) to create a 3D model of the mandibular, and the osteotomy template of the inner horizontal ramus of mandible bone incision was manufactured via 3D printing technique. All splits underwent operation with or without the osteotomy template by either a young doctor (attending doctor) or a doctor with extensive orthognathic surgery experience (chief doctor). The time it took to perform the mandible bone incision of the inner horizontal ramus of each group was recorded. Postoperative CBCT scan was performed, and the lingual split scale was used to assess the effect of the operation.

RESULTSPrimary healing of incisions was observed in all patients, and no serious complications occurred. The time it took to perform the mandible bone incision of the inner horizontal ramus was significantly different in the four groups (F=30.059, P<0.05), and it was longer in the group of the attending doctor without osteotomy template than in the other three groups (P<0.05). No significant difference was observed in the other groups (P>0.05). Although all splits (n=64) were performed according to the standardized protocol, only 59.38% (38/64) of the fracture lines run according to the Hunsuck's description. By contrast, only 21.88% (14/64) run through the mandibular canal and 18.75% (12/64) was split. The database was analyzed using crosstabs and via Fisher exact test. The split pattern was influenced by the application of an osteotomy template (P<0.05).

CONCLUSIONThe application of osteotomy template manufactured via 3D printing technique in BSSO was effective, which enabled the young doctor to complete the operation faster and with good results.

Cone-Beam Computed Tomography ; Female ; Humans ; Male ; Mandible ; Osteotomy, Sagittal Split Ramus ; Printing, Three-Dimensional

This study was aimed to establish a method to determine the content of phenolic acids in different parts ofCoptis chinensis, in order to discuss the dynamic change of phenolic acids contents in different parts and growth years ofCoptis chinensis. Contents of total phenolic acid, chlorogenic acid and ferulic acid were determined by ferric chloride-ferricyanatum calcium colorimetric method and HPLC, respectively. The results showed that the content of total phenolic acid inCoptis chinensis was in the range from 98.435 mg·g-1 to 184.456 mg·g-1. The content of chlorogenic acid and ferulic acid was in the range from 0.176 mg·g-1 to 2.227 mg·g-1, and 0.039 mg·g-1 to 0.512 mg·g-1, respectively. It was concluded that the content of phenolic acids in different parts ofCoptis chinensis were significantly different. The phenolic acids contents in different parts of Coptis chinensis reached the highest two years after transplantation, and then it expressed downswing with the increasing of growth period.

This study was aimed to establish a method to determine the content of phenolic acids in the soil of cultivation base ofCoptis chinensis, in order to study the accumulation and decrease law of phenolic acids. The content of total phenolic acid was determined by ferric chloride-ferricyanatum calcium colorimetric method. Thecontent of ferulic acid in Coptis chinensis was determined by HPLC. The results showed that the contents of total phenolic acid and ferulic acid in the soil of cultivation base of Coptis chinensis were in the range from 0.545-0.026 mg·g-1 and 0.139 to 0.652 μg·g-1, respectively. It was concluded that the variation of phenolic acids in the soil of cultivation base ofCoptis chinensis was obvious. With the increase of growth age of Coptis chinensis, the contents of total phenolic acid and ferulic acid in the soil of cultivation base of Coptis chinensis were increased in the cultivation period. With the increase of fallow age, the contents of total phenolic acid and ferulic acid in the soil of cultivation base ofCoptis chinensis showed decrease tendency in the fallow period of Coptis chinensis. The variation tendency of phenolic acids contents in the soil of cultivation base ofCoptis chinensis can be referred to in the study of the continuous cropping obstacle of Coptis chinensis.

Impacted teeth are usually involved in permanent dentition but not in primary dentition. This paper reports a clinical case of unerupted mandibular second deciduous molar inferior to the second premolar.
Bicuspid ; Dentition, Permanent ; Humans ; Mandible ; Molar ; Tooth, Deciduous ; Tooth, Impacted ; Tooth, Unerupted

Objective To study the relationship between facial skin conditions and TCM constitutional types; To provide new means and methods for guidance of skin conservation and skin health improvement from the aspect of constitutional types. Methods Totally 2241 female volunteers in nine provincial capital cities and municipalities participated in this research, and were investigated by web questionnaire. Constitutional types were determined according to the“Classification and Judgment of TCM Constitutional Types”standard issued by China Association of Chinese Medicine. Skin color, glossiness, delicate degree, moistness, firmness, resilience, uniformity and other indicators were scored. Skin conditions were classified into three groups:1-3 score group, 4-6 score group, and 7-9 score group, and the constitutional differences among each group were compared. Results Yang-deficiency and mild constitutional types accounted for the largest proportion. Yellowish skin color accounted for the largest proportion, and the next were white, dark and reddish. Yang-deficiency constitutional type accounted for the largest proportion in 1-3 score group, and the second was Qi-stagnation; Yang-deficiency and mild constitutional types accounted for the largest proportion in 4-6 score group; mild constitutional type accounted for the largest proportion in 7-9 score group. Conclusion People with mild constitutional type got highest score in every skin index, while biased constitutional types influenced the score in varied degrees. The constitutional types which influenced Chinese urban females’ facial skin index more were Yang-deficiency and Qi-stagnation constitutional types.