The study aimed to identify factors associated with treatment complications in zygomatic complex fractures (ZCF) through statistical analysis of clinical and radiologic data, providing evidence-based guidance for clinical management. Clinical records, CT scans, and follow-up data of ZCF patients treated between 2013 and 2022 were retrospectively analyzed. Key clinical features were extracted based on previous epidemiological studies. Distribution of baseline information, univariate analysis, and multivariate logistic regression were conducted to assess factors associated with treatment complications. A total of 686 ZCF patients were included with a mean age of 36.5±12.8 years and a male-to-female ratio of 2.2:1. The average injury duration was 13.6 days. Traffic accidents were the leading cause of injury (53.8%), and type B fractures were the most common (56.9%). Open reduction and internal fixation (ORIF) was the primary treatment, with 3-point fixation being the most frequent method. Complications occurred in 159 patients (23.18%), with facial asymmetry, enophthalmos, and infraorbital nerve injury being the most prevalent. Univariate analysis identified injury duration, fracture type, concomitant fractures, orbital floor defects, soft tissue injuries, treatment modality, surgical approach, fixation location and quantity, and adherence to ORIF principles as significant factors (P<0.05). Multivariate logistic regression confirmed comminuted fractures, old fractures, orbital floor defects, and ORIF principles as independent predictors of complications (P<0.05). The study indicated that injury duration, fracture types, multiple injuries, treatment modalities, surgical approaches, and fixation plans significantly impact the rate of complication in ZCF patients. Comprehensive clinical and radiologic evaluation, accurate classification, and precise treatment management are essential for optimizing treatment outcomes.

OBJECTIVE:Postoperative patients with temporomandibular joint internal derangement (ID) often have problems such as limited mouth opening and pain. Exercise therapy can be advantageous for improving the recovery of patients following surgery. However, there is continuing discussion on the precise aspects of the exercise program, including the optimal timing, length, intensity, and use of assistive equipment. Hence, this study aimed to incorporate pre-existing exercise treatment regimens and investigate their impact.METHODS:Publications that detailed the clinical treatment of patients with temporomandibular joint ID who received postoperative exercise therapy interventions were included. Nine databases were searched until October 1st, 2023. The JBI critical appraisal tools were used to assess the methodological quality of the included studies.RESULTS:Five studies were finally included for subsequent analysis; two were randomised controlled studies, and three were quasi-experimental. Exercises suitable for such patients encompass vertical, transverse, and horizontal stretching, among which vertical stretch can be divided into active and passive movements. The start time ranged from the first to the fifth week after surgery, with a duration of 1-6 months. Although the data in the studies could not be integrated and further analysed, preliminary results showed that maximum mouth opening and pain in patients improved significantly. The therapeutic effect of combining three exercise methods was best and was related to patient compliance.CONCLUSION:Exercise therapy positively affects postoperative rehabilitation in patients with temporomandibular joint ID. It is proposed that targeted, comprehensive studies be conducted to provide a basis for designing more sophisticated exercise therapy regimens and further confirm its curative effect.

Background/purposeMedication-related osteonecrosis of the jaw (MRONJ) represents a rare yet serious adverse reaction associated with the prolonged use of anti-bone resorptive or anti-angiogenic agents. This study aimed to investigate the impact and underlying mechanisms of adipose-derived stem cells (ADSCs) in preventing MRONJ in a mouse model.Materials and methodsFollowing tooth extraction in MRONJ mice, ADSCs or PBS were administered via the tail vein. The healing progress of gingival epithelium and the extraction socket was assessed using a stereoscopic microscope and histological analysis. Immunofluorescence was employed to examine markers associated with autophagy (LC3 and SQSTM1) and apoptosis (Cleaved-CASP 3). Statistical analysis involved unpaired Student's t-test and ANOVA on ABI Prism 7500, with P-values below 0.05 deemed statistically significant.ResultsADSCs enhanced gingival epithelium migration and facilitated new bone formation. In the MRONJ group, the expressions of autophagy-related protein LC3 and SQSTM1 in gingival epithelium were concurrently elevated, which indicated autophagic flux was impaired. Conversely, when treated with ADSCs, the expression of LC3 and SQSTM1 were downregulated, similarly to the Control group. Mechanically, zoledronate induced a deficiency of autophagosome–lysosome fusion in epithelial cells, while ADSCs supernatant could promote the autolysosomes formation. Furthermore, ADSCs rescued the number of autophagy-related apoptotic cells in the gingival epithelium of MRONJ.ConclusionADSCs could effectively prevent the occurrence of MRONJ, likely through the activation of autophagic flux and the inhibition of autophagy-related apoptosis in gingival epithelium. These findings enhanced the understanding of MRONJ pathogenesis and propose a potential therapeutic target for this disease.

The treatment of temporomandibular joint (TMJ) ankylosis in children is a great challenge for surgeons. Costochondral graft (CCG) is a common method of reconstructing the TMJ in children. However, the growth pattern of CCG is unpredictable. In this study, we introduced a surgical–orthodontic approach and evaluated the growth results of the mandible and maxilla in children with TMJ ankylosis through 3-dimensional computed tomography measurements. A prospective cohort study was conducted on child patients diagnosed as having TMJ ankylosis between September 1, 2018 and June 1, 2020. Computer-aided virtual mandibular position guided the CCG, and removable functional appliance was used after surgery. The maximal incisal opening (MIO), the maxilla height, and the length of mandibular ramus were determined. Paired t test was performed to analyze the differences among various stages. Six patients (3 females, 3 males; aged 6–9 y) were included in this study. MIO was 12.4 mm before surgery and improved to 36.8 mm after 42.8 months’ follow-up. Mandible length increased by 5.1 mm in the affected side and by 5.3 mm in the unaffected side, without significant difference. The affected maxilla height increased by 6.7 mm, which was more than 5.0 mm in the unaffected side. In conclusion, continued growth of mandible and maxilla can be achieved through CCG combined with functional appliance treatment for children TMJ ankylosis.

The incidence of urinary calculi in children has been increasing annually,and most of the cases are upper urinary tract stones.At present,surgery is the main way to treat upper urinary tract stones in children.With the gradual development of minimally invasive techniques in surgery,percutaneous nephrolithotomy,retrograde intrarenal surgery,and extracorporeal shock wave lithotripsy have become the main methods for treating upper urinary tract stones in children.We reviewed the current progress in surgical treatment of upper urinary tract stones in children and provided prospects for future treatment options.

This study aimed to assess the effectiveness of intraoperative computed tomography (ICT) in managing zygomatic complex (ZMC) fractures surgically. A total of 143 patients (84 men, 59 women; average age 37.13 y) undergoing surgical treatment for ZMC fractures participated in this retrospective cohort study, with 72 in the ICT group and 71 in the control group. There were no notable differences in gender, age, time from injury to surgery, and surgical duration between the two groups. The ICT group exhibited significantly fewer surgical approaches than the control group (1.39±0.519 vs. 2.07±0.617, P<0.001). Fixation points in the ICT group (1-point: 42, 2-point: 14, 3-point: 16) significantly differed from the control group (1-point: 15, 2-point: 17, 3-point: 39), P<0.001. Symmetry of reduction was assessed through immediate postoperative images, and stability was compared between immediate postoperative images and those taken at least 3 months later. Both assessments revealed no significant differences between the 2 groups. This study indicates that ICT facilitates prompt evaluation of ZMC reduction, minimizing the necessity for incisions and internal fixation, while achieving comparable reduction efficacy and long-term stability to conventional approaches.

This study aimed to assess the sensory function of the infraorbital nerve in patients with fractures of the zygomatic complex who underwent open reduction and internal fixation at different time points using quantitative sensory testing, which was established by the German Neuropathic Pain Research Network, comprising a 7-item mechanical and thermal sensory test. A total of 21 patients (age range 17-46 y, 14 males) with unilateral zygomatic complex fractures were included. Quantitative sensory testing was conducted before the operation and at 1 week, 3 months, and 6 months operatively, with cold detection threshold, warmth detection threshold, cold pain threshold, heat pain threshold, mechanical detection threshold, mechanical pain threshold, pressure pain threshold, and vibration detection threshold being measured in bilateral infraorbital regions. Notable changes in sensitivity were observed in all values except for the mechanical pain threshold. In the majority of patients with zygomaticomaxillary complex fractures, infraorbital hypoesthesia was significantly improved within 3 months postoperatively, and almost complete recovery could be achieved by 6 months postoperatively.

Reconstruction of the temporomandibular joint (TMJ) is a significant challenge in maxillofacial surgery. A vascularized medial femoral condyle (MFC) osteocartilaginous flap is a good choice for TMJ reconstruction. In this study, we evaluated the radiographic and histological changes of MFC after TMJ reconstruction. A ramus-condyle unit (RCU) defect was created unilaterally in five adult male Bama miniature pigs. The ipsilateral vascularized MFC osteocartilaginous flap was used to reconstruct the TMJ, and the non-operative sides served as controls. Multislice spiral computed tomography (CT) was performed preoperatively, immediately postoperatively, and at two weeks, three months, and six months postoperatively. Three animals were euthanized at 6 months postoperatively. Their reconstructed condyles, natural condyles and the MFCs on the opposite side were collected and subjected to µCT and histological evaluation. In the miniature pigs, the vascularized MFC osteocartilaginous flap was fused to the mandible, thus restoring the structure and function of the RCU. The postoperative radiographic changes and histological results showed that the reconstructed condyle was remodeled toward the natural condyle, forming a similar structure, which was significantly different from the MFC. In miniature pigs, the RCU can be successfully reconstructed by vascularized osteocartilaginous MFC flap. The reconstructed condyle had almost the same appearance and histological characteristics as the natural condyle.

This study aimed to evaluate the soft tissue prediction accuracy of patients undergoing orthognathic surgery to correct skeletal class III malocclusion using maxillofacial regional aesthetic units. Pre- and postoperative cone-beam computed tomography (CBCT) and 3D facial scans were taken for 58 patients who had undergone orthognathic surgery. The preoperative 3D facial scan was integrated with the preoperative CBCT using ProPlan CMF software. The software simulated the surgery and generated postoperative soft tissue prediction. The simulated 3D facial scan was then compared with the actual 3D facial scan obtained at least 6 months after the surgery by the maxillofacial regional aesthetic units and the facial soft tissue landmark points. The anatomical regions of the upper lip, lower lip, chin, right external buccal and left external buccal prediction were above 2.0 mm. As for the soft tissue landmarks, at chl, chr, ls, stm and li, the position of predicted scan was higher than that of the actual postoperative scan. The accuracy of 3D soft tissue predictions using ProPlan CMF software in Skeletal III patients was clinically satisfactory according to maxillofacial regional aesthetic units combined with facial soft tissue landmark points. However, the accuracy of prediction still needed improvement in some areas. The accuracy of soft tissue prediction can be analyzed more clearly through maxillofacial regional aesthetic units so that clinicians have a deeper understanding of the use of the software to predict soft tissue change after orthognathic surgery.

The use of the white-light thoracoscopy is hampered by the low contrast between oncologic margins and surrounding normal parenchyma. As a result, many patients with in situ or micro-infiltrating adenocarcinoma have to undergo lobectomy due to a lack of tactile and visual feedback in the resection of solitary pulmonary nodules. Near-infrared (NIR) guided indocyanine green (ICG) fluorescence imaging technique has been widely investigated due to its unique capability in addressing the current challenges; however, there is no special consensus on the evidence and recommendations for its preoperative and intraoperative applications. This manuscript will describe the development process of a consensus on ICG fluorescence-guided thoracoscopic resection of pulmonary lesions and make recommendations that can be applied in a greater number of centers. Specifically, an expert panel of thoracic surgeons and radiographers was formed. Based on the quality of evidence and strength of recommendations, the consensus was developed in conjunction with the Chinese Guidelines on Video-assisted Thoracoscopy, and the National Comprehensive Cancer Network (NCCN) guidelines on the management of pulmonary lesions. Each of the statements was discussed and agreed upon with a unanimous consensus amongst the panel. A total of 6 consensus statements were developed. Fluorescence-guided thoracoscopy has unique advantages in the visualization of pulmonary nodules, and recognition and resection of the anterior plane of the pulmonary segment. The expert panel agrees that fluorescence-guided thoracoscopic surgery has the potential to become a routine operation for the treatment of pulmonary lesions.

Cancer cell lines are extremely valuable tools for carcinoma research. Biodiversity of cell lines and continuous random mutation in cell lines during passage, however, might result in phenotypic inconsistency and lead to biased experimental conclusions. Using statistics based on known and inferred protein interaction networks, as well as public research literature database, our study shows that essential driver genotypes of cell lines might have hidden impact on research results. Furthermore, by comprehensive genomic profiling of 8 most common used urothelial cell lines and comparing them to previous publications, we found that regardless of similar short tandem repeat (STR) profile, driver gene loss in cell lines could happen by random mutation. Our results suggest that clinical research using urothelial carcinoma cell lines might be influenced by cell line genotypes which could only be determined by next-generation sequencing. Meanwhile, this study indicates that the conditionally reprogrammed cells (CRCs), which closely resemble original tumor tissue, might represent a better alternative for in vitro research, which may be better used for personalized medicine.

骨关节炎(OA)与骨质疏松症(OP)的关系争论颇多,尚无定论.对二者关系的研究已有相当长的时间,目前仍被众多学者所关注.既往对OP的研究主要集中在腰椎与股骨近端,很少涉及膝关节.随着对膝骨关节炎(KOA)的认识不断深入以及骨密度(BMD)测量技术的不断改进,近年来有一些学者尝试使用双能X线吸收法(DXA)、定量CT(QCT)等方法对KOA患者膝关节局部BMD进行测量、研究,获得了一些初步的结果.本文对相关研究进行综述,分析总结KOA患者膝关节局部BMD的测量方法及变化规律.

Objective: To evaluate the efficacy and safety of an intraoperative betamethasone periarticular injection in patients undergoing primary unicompartmental knee arthroplasty (UKA). Methods: Seventy patients with knee anteromedial osteoarthritis who underwent the primary unilateral UKA in China-Japan Friendship Hospital from July 2017 to October 2018 were randomized into two groups with random number table. In the group A, an analgesic mixture of morphine, ropivacaine, epinephrine, ketorolac and betamethasone was infiltrated intraoperatively into the soft tissue. While in the group B, a same volume of mixture without betamethasone was injected alternatively. The visual analogue scale (VAS) of pain and analgesic consumption were evaluated to compare the effectiveness of pain control between the two groups. In addition, maximal flexion of the knee andinitial time of the straight leg raising were monitored. Complications were assessed too. The data were compared with independent-sample t test. Results: No significant differences in VAS score was found between the groups at 6 h and 12 h after the operation (t=-1.154, -1.108, both P>0.05), but the pain level and analgesic consumption were significantly lower in the group A from 18 h to 72 h post operation (t=-2.959, -2.808, -2.080, -2.519, -3.378, -3.237, all P<0.05). The maximal flexion in group A was significantly higher than that in the group B from 1 d to 3 d (t=2.985, 4.575, 4.013, all P<0.05). The straight leg raising ability and incidence of complications were similar between the groups (χ(2)=0.141, 0.000, both P>0.05). Conclusions: The cocktail analgesics injection containing small dose of betamethasone during UKA can provide effective acute pain control early after the surgery, which is conducive to knee joint function, and it does not increase the incidence of postoperative complications.

Purpose: The purpose of the present study was to determine the correlation between the soft and hard tissue changes in the zygomaticomaxillary region after facial bone contouring surgery for patients with craniofacial fibrous dysplasia (FD). Materials and Methods: The present study was a retrospective case series that reviewed the cases of 13 patients with craniofacial FD in the zygomaticomaxillary region who had undergone navigation-guided facial bone contouring surgery from January 2013 to October 2017. Pre- and postoperative computed tomography (>3 months) were collected. The pre- and postoperative soft and hard tissues were placed in the same spatial coordinate system using multipoint registration to measure the distances between the corresponding pre- and postoperative points of the soft and hard tissues. The outcome variable was the corresponding soft tissue change. The correlation between the hard and soft tissue changes was obtained using correlation analysis with SPSS software (IBM Corp, Armonk, NY). The linear regression equation of the soft and hard tissue changes was used to predict the corresponding soft tissue changes. Results: The Pearson correlation coefficient of the zygomatic region was 0.954 (P < .001) and the coefficient for the maxillary region was 0.758 (P < .001). The linear regression index (R-2) for the zygomatic and maxillary regions was 0.910 (P < .001) and 0.575 (P < .001), respectively. The beta value of the linear regression equation for the zygomatic and maxillary regions was 0.815 (P < .001) and 0.52 (P < .001), respectively. Conclusions: The soft and hard tissue changes were highly correlated in both the zygomatic area and the maxillary area, and the variance of the maxillary area was slightly greater than that in the zygomatic area. This implied that the change of 1 mm of bone tissue along the tangent direction of the bone contour will cause a change of 0.815 mm in the soft tissue in the zygomatic region and 0.52 mm in soft tissue in the maxillary region. (C) 2019 American Association of Oral and Maxillofacial Surgeons

This study aimed to evaluate the effect of laterally-based pedicled cranial bone flap (LBPCBF) for the repair of secondary zygomaticomaxillary defects. Between December 2014 and December 2016, 6 patients with unilateral zygomaticomaxillary defects were selected; of these, 5 had trauma, and 1 was exposed to titanium mesh in the infraorbital area due to radiotherapy following total maxillectomy for right maxillary squamous cell carcinoma. Preoperatively, 3 patients suffered from an intraoral vestibular groove fistula, 2 suffered from an extraoral fistula, and 1 from local exposure of titanium mesh. Surgical treatment was implemented in all 6 patients, of which, the 5 trauma patients underwent debridement, reduction, and fixation of periorbital fracture, followed by repair of the defects in the infraorbital margin, anterior wall of maxillary sinus, and zygomatic body with LBPCBF, and then, reconstruction of the orbital floor with titanium mesh. The other patient with exposed titanium mesh underwent repair of defects in the infraorbital margin and anterior wall of the maxillary sinus with LBPCBF after titanium mesh trimming. Postoperative review at 6 months revealed disappearance of intraoral fistula, wound healing, and improvement of facial deformity in all 6 patients, of which 2 patients demonstrated postoperative ectropion. The application of LBPCBF can simultaneously repair bone defects in the infraorbital margin, anterior wall of maxillary sinus, and zygomatic body, as well as, supplement the soft tissue, thereby indicating a satisfactory treatment effect.

Stability has been one of the most fundamental premises in biometric recognition field. In the last few years, a few achievements have been made on proving this theoretical premises concerning fingerprints, palm prints, iris, face, etc. However, none of related academic results have been published on finger-vein recognition so far. In this paper, we try to study on the stability of finger-vein within a designed timespan (four years). In order to achieve this goal, a proper database for stability was collected with all external influences of finger-vein features (acquiring hardware, user behavior and circumstance situation) eliminated. Then, for the first time, we proposed a steady-state model of finger-vein features indicating that each specific finger owns a stable steady-state which all its finger-vein images would properly converging to, regardless of time. Experiments have been conducted on our 5-year/200,000-finger data set. And results from both genuine match and imposter match demonstrate that the model is well supported. This steady-state model is generic, hence providing a common method on how to evaluate the stability of other types of biometric features.

目的:观察应用肌骨超声引导针刀治疗腰椎关节突关节源性腰痛的疗效,为本病的治疗提供一种新方法.方法:回顾2017年3月至2017年10月期间,北京中医药大学第三附属医院采用肌骨超声引导下针刀治疗腰椎关节突关节源性腰痛35例:其中男11例,女24例;年龄31～66岁,平均47.5岁;病史1 d～41个月.术后1周、2周及4周随访收集Oswestry功能障碍评分信息(ODI评分).术后10 min、1周及2周收集VAS评分信息.对患者治疗前后ODI评分、VAS评分进行分析比较,总结疗效.结果:1周后有5例病人ODI评分无好转,总有效率为85.7％.术后10 min VAS评分无改变7例,总有效率80％.均无并发症发生.术前后ODI评分、VAS评分分别行重复测量资料的单因素分析统计,差异有统计学意义(P＜0.05).结论:1)肌骨超声引导下针刀治疗定位准确,对腰椎关节突关节源性腰痛疗效显著;2)肌骨超声引导下针刀治疗操作安全,无并发症,可明显改善患者生活质量.

Foot is a vital part of human, and lots of valuable information is embedded. Plantar pressure is one of which contains this information and it describes human walking features. It is proved that once one has trouble with lower limb, the distribution of plantar pressure will change to some degree. Plantar pressure can be converted into images according to some simple standards. In this paper, we take full advantage of these plantar pressure images for medical usage. We present N2RPP, a generative adversarial network (GAN) based method to rebuild plantar pressure images of anterior cruciate ligament deficiency (ACLD) patients from low dimension features, which are extracted from an autoencoder. Through the result of experiments, the extracted features are a useful representation to describe and rebuild plantar pressure images. According to N2RPP's results, we find out that there are several noteworthy differences between normal people and patients. This can provide doctors a rough direction of adjusting plantar pressure to a better distribution to reduce patients' sore and pain during the rehabilitation treatment for ACLD.