Correlation Between Body Mass Index and Anterolateral Thigh Flap Thickness: A Retrospective Study From a Single Center in China

Background: During repair of oral and maxillofacial soft tissue defects, organ function is largely related to the amount of thickness of the flap. However, there are few studies on the influencing factors of the thickness of the flap. In this retrospective study, we aim to explore the correlation between body mass index (BMI) and anterolateral thigh (ALT) flap thickness by computed tomography (CT) and ultrasound and provide guidance for evaluating the ALT flap thickness before surgery. Methods: We selected three points A, B, and C on ALT flap and two skilled clinicians measured the thickness of these points. Age and gender as covariates and evaluated by the Chi-square analysis. Inter-group differences between the two BMI groups were examined by the student t test. Intra-group differences within each BMI group were tested by ANOVA. Linear regression analysis was performed to examine the relationship between BMI and ALT flap thickness. Results: One hundred sixty patients measured by CT were included in this study, and the ALT flap thickness measured by CT were 8.96 mm and 11.00 mm (P < 0.0001, t test) at point B in groups with BMI<24.0 and BMI≥24.0, respectively. The thicknesses at points A, B, and C were significantly correlated with the BMI (P < 0.001, correlation analysis, r = 0.462, 0.372, and 0.349 at the points A, B, and C, retrospectively, Pearson test). Conclusion: There was a significant correlation between the ALT flap thickness and BMI. A higher BMI was correlated with a thicker ALT flap.

Analysis, occurrence, toxicity and environmental health risks of synthetic phenolic antioxidants: A review

The continuous improvement of living standards is related to higher requirements for the freshness and taste of food. For example, synthetic phenolic antioxidants (SPAs) are added to fats and fried foods as food additives to minimize the oxidative rancidity of oils and fats. Hence, the global use of SPAs is increasing year by year. Dibutyl hydroxytoluene is one of the widely used SPAs, often in combination with butyl hydroxyanisole or gallate SPAs. The extensive use of these compounds makes them and their transformation products to be widespread in various environmental matrices, including indoor dust, wastewater, river water, sewage sludge, and sediment, as well as human samples, such as nails and urine, at concentrations varying from nanogram per gram (ng/g) to microgram per gram (μg/g). Animal experiments have shown that high-dose SPA exposure is toxic, which may lead to DNA damage and mismatches and the development of cancerous tumors. Since the biosphere shares the same set of genetic codes, humans and animals have many identical or similar feedback mechanisms and information pathways. Therefore, the damage of SPAs to animals may also threaten human health. This review discusses the properties, occurrence, analysis, and environmental health risks of typical SPAs, including butyl hydroxyanisole, dibutyl hydroxytoluene, tert-butylhydroquinone, propyl gallate, octyl gallate, and lauryl gallate, used as food additives. In addition, AO2246, which is used in food packaging bags, is also considered. Future research directions on SPAs and their transformation products (TPs) are identified and discussed.

Increased symptoms of post-traumatic stress in school students soon after the start of the COVID-19 outbreak in China

BACKGROUND

The outbreak of Coronavirus Disease 2019(COVID-19) caused psychological stress in Chinese adults population. But we are unaware of whether the pandemic causes psychological stress on children.

METHODS

We used the Children's Impact of Event Scale questionnaire (CRIES-13) to investigate the degree of Post-traumatic Stress (PTSD) symptoms caused by the pandemic in students selected from schools in Sichuan, Jiangsu, Henan, Yunnan, and Chongqing provinces of China.

RESULTS

A total of 7769 students(3692 male and 4077 female), aged 8-18 years, were enrolled in the study, comprising 1214 in primary schools, 2799 in junior high schools and 3756 in senior high schools. A total of 1639 students (21.1%) had severe psychological stress reactions. A large proportion of senior high school students (23.3%) experienced severe psychological stress, and they had the highest median total CRIES-13 score. Female students were more likely to experience severe psychological stress and had higher median CRIES-13 total scores than males.

CONCLUSION

COVID-19 has placed psychological stresses on primary and secondary school students in China. These stresses are more likely to reach severe levels among female students and senior high school students.

A Chemistry and Microstructure Perspective on Ion-Conducting Membranes for Redox Flow Batteries

Redox flow batteries (RFBs) are among the most promising grid-scale energy storage technologies. However, the development of RFBs with high round-trip efficiency, high rate capability, and long cycle life for practical applications is highly restricted by the lack of appropriate ion-conducting membranes. Promising RFB membranes should separate positive and negative species completely and conduct balancing ions smoothly. Specific systems must meet additional requirements, such as high chemical stability in corrosive electrolytes, good resistance to organic solvents in nonaqueous systems, and excellent mechanical strength and flexibility. These rigorous requirements put high demands on the membrane design, essentially the chemistry and microstructure associated with ion transport channels. In this Review, we summarize the design rationale of recently reported RFB membranes at the molecular level, with an emphasis on new chemistry, novel microstructures, and innovative fabrication strategies. Future challenges and potential research opportunities within this field are also discussed.

Nanoscale cobalt-based metal-organic framework impairs learning and memory ability without noticeable general toxicity: First in vivo evidence

Metal-organic frameworks (MOFs) exhibit broad potential applications in the environmental, biomedical, catalyst, and energy fields. However, the currently existing data hardly shed light on their health risks before the MOFs' large-scale usage. In this context, we exploratively investigated the in vivo fate and effect of one representative cobalt-based zeolitic imidazolate framework (ZIF-67) at the nano- (60 nm) and submicron- (890 nm) scales. Different from submicron-scale ZIF-67 showing better biosafety, nanoscale particles manifested a neurodegenerative risk at the dose of no general toxicity, evidenced by the impairment of learning and memory ability and disordered function of the neuropeptide signaling pathway in a rat model. The involvement of oxidative damage and inflammatory processes in the neurotoxicity induced by ZIF-67 was discussed as well. These findings not only provide a wake-up call for the prudent applications of MOFs but also provide insight into the better design and safer use of MOFs for broader applications.

Influence of 4-week or 12-week glucocorticoid treatment on metabolic changes in patients with active moderate-to-severe thyroid-associated ophthalmopathy

Thyroid‐associated ophthalmopathy (TAO) is a serious, progressive, vision‐threatening and difficult‐to‐treat organ‐specific autoimmune disease. The course, therapeutic effects and prognosis of moderate to severe TAO vary greatly. High‐dose intravenous glucocorticoid (IVGC) therapy is considered a first‐line treatment for active moderate‐to‐severe TAO, but there is still insufficient evidence regarding the treatment duration. Long‐term IVGC therapy can influence the metabolism of glucose, lipids, and bone. This study was designed to compare changes in metabolic and immunological indexes as well as the magnetic resonance imaging apparent diffusion coefficient (ADC) of the extraocular muscles after 4 and 12 weeks of IVGC therapy. Forty‐eight patients with active moderate‐to‐severe TAO were included in this retrospective cohort study. Metabolism and immunological indexes were measured before and after therapy. The ADC and clinical activity score (CAS) were used to evaluate the efficacy of treatment in these patients. We found that the patients in the 12‐week group had increased fasting plasma glucose (p = 0.004), glycated hemoglobin (p = 0.028), total cholesterol (p < 0.001), and low‐density lipoprotein (p < 0.001) after therapy. The patients in both groups had reduced bone metabolism markers after therapy. Thyroid peroxidase antibody and thyrotropin receptor antibody levels decreased after treatment in both groups (p < 0.001). A significant decrease in thyroglobulin antibody levels was found in the 4‐week group (p = 0.006). The change in the ADC was higher in the 4‐week group than in the 12‐week group (p = 0.014). However, there were no significant differences in CAS values between the two groups. Therefore, 4‐week IVGC therapy was recommended for patients with TAO with glucose and lipid disorders.

Genetic diversity and molecular epidemiological characterization of group A rotaviruses in raw sewage in Jinan by next generation sequencing

OBJECTIVE

To understand the genetic diversity and molecular epidemiology characteristics of group A Rotavirus (RVA) in domestic sewage through next generation sequencing (NGS), and to explore the feasibility and necessity of NGS method for RVA environmental surveillance.

METHODS

In this study, two sewage samples from Jinan each quarter in 2019 were selected for concentration, RNA extraction, and then RT-PCR reaction. The amplified positive products were subjected to NGS. Finally, the results were analyzed for diversity and phylogeny.

RESULTS

A total of 9 G-genotypes and 13 P-genotypes were detected. The Simpson diversity indices in autumn and winter were relatively high. Phylogenetic analysis showed that the dominant types G9 and P[8] were closely related to human-derived sequences.

CONCLUSIONS

This study proves that environmental surveillance as a means to understand the prevalence of RVA in the population is not only feasible but necessary. NGS based environmental surveillance greatly improves our understanding on RVA genetic diversity, and should be encouraged as a sensitive surveillance tool.

The multi-kinase inhibitor TG02 induces apoptosis and blocks B-cell receptor signaling in chronic lymphocytic leukemia through dual mechanisms of action

The constitutive activation of B-cell receptor (BCR) signaling, together with the overexpression of the Bcl-2 family anti-apoptotic proteins, represents two hallmarks of chronic lymphocytic leukemia (CLL) that drive leukemia cell proliferation and sustain their survival. TG02 is a small molecule multi-kinase inhibitor that simultaneously targets both of these facets of CLL pathogenesis. First, its inhibition of cyclin-dependent kinase 9 blocked the activation of RNA polymerase II and transcription. This led to the depletion of Mcl-1 and rapid induction of apoptosis in the primary CLL cells. This mechanism of apoptosis was independent of CLL prognostic factors or prior treatment history, but dependent on the expression of BAX and BAK. Second, TG02, which inhibits the members of the BCR signaling pathway such as Lck and Fyn, blocked BCR-crosslinking-induced activation of NF-κB and Akt, indicating abrogation of BCR signaling. Finally, the combination of TG02 and ibrutinib demonstrated moderate synergy, suggesting a future combination of TG02 with ibrutinib, or use in patients that are refractory to the BCR antagonists. Thus, the dual inhibitory activity on both the CLL survival pathway and BCR signaling identifies TG02 as a unique compound for clinical development in CLL and possibly other B cell malignancies.

Occurrence, fate, and risk assessment of typical tetracycline antibiotics in the aquatic environment: A review

Tetracyclines (TCs), used as human and veterinary medicines, are the most widely used antibiotics. More than 75% of TCs are excreted in an active form and released into the environment through human and animal urine and feces, causing adverse effects on the ecological system and human health. Few articles review the environmental occurrence and behaviors of TCs, as well as their risks and toxicities. Here, we comprehensively summarized the recent advances on the following important issues: (1) Environmental occurrence of TCs. TCs are used globally and their occurrence in the aquatic environment has been documented, including surface water, groundwater, drinking water, wastewater, sediment, and sludge. (2) Environmental behaviors of TCs, particularly the fate of TCs in wastewater treatment plants (WWTPs). Most WWTPs cannot effectively remove TCs from wastewater, so alternative methods for efficient removal of TCs need to be developed. The latest degradation methods of TCs are summarized, including adsorption, photocatalytic, photochemical and electrochemical, and biological degradations. (3) Toxicities and possible risks of TCs. The toxicological data of TCs indicate that several TCs are more toxic to algae than fish and daphnia. Risk assessments based on individual compound exposure indicate that the risks arising from the current concentrations of TCs in the aquatic environment cannot be ignored.

Antifungal sesquiterpenes with post-harvest anthracnose control effect on bananas from the fungus Fusarium lateritium

To search for antifungal leads, the metabolites of an insect-derived fungus Fusarium lateritium ZMT01 were investigated, providing five sesquiterpenes (1-5), including new molecules microsphaeropsisins D and E (1 and 2). The evaluated antifungal activities in vitro which are higher than the positive control triadimefon include: 1 and 2 towards Fusarium oxysporum (MICs 50, 25 mg L^-1; triadimefon 100 mg L^-1); 1, 2, 4 and 5 towards Penicillium italicum (MICs 25, 12.5, 25, 25; triadimefon 50 mg L^-1), 1, 2 and 4 towards Colletotrichum musae (MICs 25, 12.5, 25; triadimefon 80 mg L^-1), 2 and 4 towards Fusarium graminearum (MICs 100, 100; triadimefon 150 mg L^-1). The bioassay in vivo displayed that the banana anthracnose control effect of 2 (100 mg L^-1) was also higher than that of triadimefon (Inhibition ratios 27.5 ± 2.5%, 55.3 ± 1.4%, 52.1 ± 1.3% for 2, 22.5 ± 2.1%, 47.2 ± 2.0%, 36.6 ± 2.2% for triadimefon at 4 d, 8 d and 12 d, respectively).

[Analysis of the clinical features and the risk factors of severe adenovirus pneumonia in children]

Objective: To analyze the clinical characteristics, risk factors for critical illness and death of severe adenovirus pneumonia in children, so as to provide clinical evidences for early diagnosis and reliable treatment. Methods: A total of 75 pediatric cases with severe adenovirus pneumonia admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to October 2019 were studied. The clinical features, laboratory and imaging data, therapeutic approaches, efficacy of the treatments and prognosis were investigated retrospectively. Patients were divided into severe group and critical group. Chi square test and Mann-Whitney U rank sum test were used to analyze the data of the two groups. The risk factors for critical illness and death were analyzed by univariate and multivariate Logistic regression. Results: Among the 75 children, there were 52 males and 23 females, aged from 3 months to 8 years, including 30 of severe cases and 45 of critical case. The positive rate of adenovirus antigen in nasopharyngeal swab was 21% (15/72), and the positive rate of serum adenovirus IgM antibody was only 13% (10/75). However, the positive rate of adenovirus nucleic acid in nasopharyngeal swab was 75% (21/28). What is more, the positive rates of metagenomics next generation sequencing (mNGS) in plasma and bronchoalveolar lavage fluid were 92% (33/36) and 96% (54/56), respectively, of which 95% (63/66) were confirmed as adenovirus type 7. Relatively high dose of ribavirin and integrated therapeutic approaches (respiratory support, glucocorticoids, immunoglobulin and organ supportive therapies) were used. The recovery rate was 77% (58/75), the improvement rate was 8% (6/75) and the mortality rate was 15% (11/75). The proportion of children with the duration of fever longer than 3 days after ribavirin treatment in the critical group was significantly higher than that in the severe group(51% (18/35) vs. 8% (2/26), χ²=12.949, P<0.05). The risk factors for critical illness were younger than 4 years, longer duration of fever before and after admission to PICU, oxygenation index<300 mmHg (1 mm Hg=0.133 kPa), ferritin>1 000 μg/L, lactate dehydrogenase (LDH)>1 500 U/L, 5 lung lobes involvement, pleural effusion and (or) air leakage (all P<0.05). Among them, 5 lung lobes involvement was the independent risk factor for critical illness (adjusted OR=49.641, 95%CI 4.186-588.618, P=0.002). Risk factors for death included longer duration of fever after being admitted to PICU, oxygenation index<100 mmHg, ferritin>2 000 μg/L, interleukin (IL)-6>100 ng/L, LDH>1 500 U/L, pleural effusion and (or) air leakage (all P<0.05). Among them, IL-6>100 ng/L was the independent risk factor for the mortalities of critically ill children (adjusted OR=16.094, 95%CI 2.059-25.787, P=0.008). Conclusions: The mortality rate of severe pediatric adenovirus pneumonia caused by adenovirus type 7 is high. High positive rates of adenovirus nucleic acid in nasopharyngeal swabs and mNGS in plasma or bronchoalveolar lavage fluid contribute to early diagnosis, and mNGS can also be used for serotyping. Younger children under 4 years of age, persistent fever, extensive pulmonary lesions and significantly increased inflammatory cytokines such as IL-6 are warning indicators for critical illness and poor prognosis. Relatively high dose of ribavirin combined with integrated therapeutic approaches are beneficial for prognosis.

Prevalence and Bayesian Phylogenetics of Enteroviruses Derived From Environmental Surveillance Around Polio Vaccine Switch Period in Shandong Province, China

We present the results of environmental surveillance for poliovirus (PV) and non-poliovirus (NPEV) around the switch from trivalent to bivalent oral polio-vaccine (OPV) which occurred in China in May 2016. Sewage samples were collected in Jinan and Linyi city from 2015 to 2017. Enterovirus (EV) isolation, VP1 amplification, Sanger sequencing, and phylogenetic analyses were performed. Among105 sewage samples (36 in Jinan and 69 in Linyi), 101 were positive for EV, with 74.3% (78/105) PV-positive samples and 90.5% (95/105) NPEV-positive samples. A total of 893 EV isolates were obtained, including 326 (36.5%) PVs and 567 (63.5%) NPEVs. Echovirus (E) -11 was the most common serotype out of 18 detected NPEV types (120/567), followed by E-3 (75/567) and E-6 (74/567). PV2 vanished and PV3 came to be the ascendant PV type in sewage after May 2016. Eight PV isolates were judged as pre-vaccine-derived poliovirus (pre-VDPV) and no VDPV or wild PV isolates were monitored. Bayesian phylogenetics demonstrated global E-11 originated in 1876 and evolved with the estimated rate of 4.63 × 10^-3 nucleotide substitutions per site per year (s/s/y). Multiple circulating clusters that originated at different times were coexisting in Shandong province. The most recently common ancestor of global coxsackievirus B5 could date back to 1867, at the evolutionary rate of 3.95 × 10^-3 s/s/y. In conclusion, our study described the changes of PVs and NPEVs around the polio vaccine switch period and provided meaningful global molecular epidemiological data for further studies of EV-related diseases among the population.

[Tap-hammer elicited vestibular-evoked myogenic potentials system: its design and preliminary application]

Objective: The aim of this study was to design and perform "Tap-hammer"system that can be used to elicit vestibular evoked myogenic potentials (VEMP) in normal adults and to report the preliminary results of this system. Methods: A triggered Tap-hammer was designed, made and connected with an electric recording system, to form as a system for Tap-VEMP recording. Twenty healthy adult volunteers (7 males and 13 females, aged 20 to 37 years, 40 ears in total) were recruited for air-conducted sound VEMP (ACS-VEMP) and Tap-VEMP examinations. Waveforms and parameters of both VEMPs were recorded and analyzed. SPSS 22.0 software was used for statistical analysis. Results: The response rates of ACS-, Tap-ocular VEMP (oVEMP) and ACS-, Tap-cervical VEMP (cVEMP) were both 100% (40/40). The mean±SD n1 latency, p1 latency, n1-p1 interval, amplitude, and asymmetry ratio (AR%) of Tap-oVEMP were (9.80±2.51)ms, (13.90±3.26)ms, (4.09±1.43)ms, (16.43±9.61)μV, (22.68±17.35)% respectively. The mean±SD p1 latency, n1 latency, p1-n1 interval, amplitude, and asymmetry ratio (AR%) of Tap-cVEMP were (13.26±2.07)ms, (21.84±2.89)ms, (8.58±2.10)ms, (457.65±274.94)μV, (20.42±13.46)% respectively. Both n1 latency and p1 latency of Tap-VEMPs were shorter than those in ACS-VEMPs (P<0.05). No statistical difference could be found between the two stimulation methods in the parameters of n1-p1 interval, amplitude, and asymmetry ratio(P>0.05). Conclusion: The Tap-hammer system can elicit VEMP responses in healthy young people. This system can be used as an alternative stimulation method for bone conduction VEMP.

Photonic hyperthermal and sonodynamic nanotherapy targeting oral squamous cell carcinoma

Nanomedicine that enables multiple synergetic treatments provides effective non-invasive treatment modalities for cancer therapy. Yet treatments for oral squamous cell carcinoma (OSCC) are rarely reported. Here, we designed OSCC-targeting multi-functional nanomedicines to overcome the therapeutic obstacles during OSCC treatments, including ineffective chemotherapy, and the traumatic surgery and radiotherapy. The urokinase plasminogen activator receptor (uPAR)-targeting ligand AE105 decorated dendritic mesoporous silica nanoparticles (DMSN) encapsulating photonic active ultrasmall Cu2-xS NPs and sonosensitizer Rose Bengal (RB) have been rationally designed and constructed (designated as Cu2-xS-RB@DMSN-AE105, abbreviated as CRDA). These CRDAs initially target the uPAR, which is overexpressed in the OSCC cell membrane, to increase the localized accumulation of CRDAs at tumor sites. Under the irradiation of both near-infrared laser and ultrasound, the in situ photonic-hyperthermal and sonodynamic effects are respectively enabled to induce the cell death of OSCC. Upon both in vitro/in vivo challenges, tumor cells/xenografts have been efficiently eradicated, achieving the targeting and synergetic treatment modality against the OSCC with satisfactory biocompatibility.

Detection of enteroviruses in urban sewage by next generation sequencing and its application in environmental surveillance

Environmental surveillance has been used successfully in monitoring enterovirus (EV) circulation; however cell culture method may introduce a selective bias in those EV strains that are recovered from the environment. In this study, urban sewage samples were collected monthly in Jinan, China in 2018 and concentrated via membrane adsorption/elution method. A P1 seminested RT-PCR (RT-snPCR) and NGS method was developed, by which amplicons of 4000 nucleotide in length covering the entire P1 region of EVs were obtained from sewage concentrates and were further analyzed by next generation sequencing (NGS). In addition, for each sewage concentrate, two other assays - cell culture and NGS based partial VP1 amplicon sequencing - were conducted in parallel and compared. The results showed that the P1 RT-snPCR and NGS method generated the most data, with 32 serotypes identified belonging to species EV-A (n = 11), EV-B (n = 14), and EV-C (n = 7). These serotypes covered all those detected from the methods of cell culture (n = 10) and partial VP1 amplicon sequencing (n = 16). EV serotypes from acute flaccid paralysis surveillance correlated with those from sewage. Phylogenetic analysis on coxsackievirus B5, a common pathogen of meningitis, revealed close genetic relationship between environmental and clinical sequences. These results demonstrate sewage contains different EVs related to a variety of diseases. Traditional cell culture method underestimates the existence of some serotypes. NGS based environmental surveillance provides data which are consistent with those from clinical diseases, greatly improves our understanding on the actual circulation in the population, and should be encouraged for public health surveillance.

Role of ultrasound in diagnosis and differential diagnosis of deep infantile hemangioma and venous malformation

OBJECTIVE

For vascular anomalies, when clinical findings are not sufficient, auxiliary examination is essential. In this study, we characterize and differentiate the ultrasound (US) findings of deep infantile hemangioma (DIH) and venous malformation (VM).

METHODS

A total of 135 patients (140 lesions) with clinically proven DIH and VM were analyzed. The following US characteristics were assessed: size, shape, border, echogenicity, echotexture, vascularity, and lesion softness. One-way analysis of variance, nonparametric test, χ² test, Fisher exact test, and paired sample t-test were used to analyze the US results.

RESULTS

On gray-scale US images, DIH and VM were more common in subcutaneous soft tissue, but VM could invade the muscle. Most DIHs were expressed as hyperechoic structures (47.0%), had a well-defined border (74.2%), and were homogeneous (53%), whereas the majority of VMs showed mixed echoic with anechoic structures (87.8%), had an ill-defined border (58.1%), and were heterogeneous (100%). On color Doppler US, most DIHs (90.9%) showed high vascular density, whereas only a few blood flow signals were found in most VMs (98.6%). On elastic US, VM was softer than DIH (2.9 ± 0.8 vs 2.6 ± 0.5; P = .048). After DIH involution, the distance from the body surface increased (P = .015); the lesion's vertical diameter, peak arterial systolic velocity, and Vmax were significantly decreased (P = .006, P = .047, and P = .026, respectively). Also, early VM (<18 months) has the typical US performance of VM. Compared with elastic US, gray-scale and Doppler US provided stronger evidence for differential diagnosis.

CONCLUSIONS

DIH and VM have different US manifestations that can provide evidence for diagnosis and differential diagnosis of DIH and early VM.

[Application of intraoral ultrasonic imaging in diagnosis and treatment of 18 patients with oral leukoplakia in non-masticatory mucosa]

PURPOSE

To explore the sonographic appearance of leukoplakia in non-masticatory oral mucosa, classifying mucosal leukoplakia according to the characteristics of sonogram, and providing reference for clinical diagnosis and treatment.

METHODS

Eighteen patients (24 lesions) were diagnosed as oral leukoplakia at the Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital. The lesions were located in the tongue, floor of mouth, buccal mucosa and libial mucosa. Before the biopsy was taken, intra-oral path ultrasound was performed at the Department of Ultrasound to observe the lesion's extent, continuity, presence or absence of keratinization, the thickness of each layer in the epithelium, and color doppler flow imaging of the lesions. Quantitative analysis software 'Qontraxt' was used to randomly measure the relative echo intensity of the mucosal surface in leukoplakia areas, and summarize the keratinization type. SPSS 25.0 software package was used for statistical analysis of the data, and paired t test was used for inter-group comparison of the data.

RESULTS

Oral leukoplakia sonograms showed that the epithelial layer appeared keratinization, the epithelial was thickened, and the echo was enhanced. The stratum intermedium showed a low echo thickening band, and the echo of partial lesions' surface decreased or the blood flow signal in oral mucosa increased. The hyperechoic band in the leukoplakia area was significantly thickened (P<0.001), and the echo was enhanced, with the tongue and buccal mucosa being the most significant. The hypoechoic band was significantly thicker (P<0.001), with the buccal mucosa and labial mucosa being the most significant. The surface and stratum corneum echo intensity values were determined by Qontraxt quantitative analysis software to determine whether there were keratinization and the keratinization types. The echo intensity values was 43.28±9.33 in non-OLK area, 92.88±3.12 in OLK with orthokeratosis, and 84.75±5.76 in OLK with parakeratosis.

CONCLUSIONS

Ultrasound imaging can effectively define mucosal leukoplakia and measure the thickness of each layer in the epithelium. In addition, special adjoint changes such as ulcers, infections and cancerous changes can be detected. Intraoral ultrasonic imaging can provide imaging evidence for clinical diagnosis, treatment planning and post-treatment follow-up and contribute to avoid unnecessary mucosal iatrogenic injury or recurrence of disease after treatment.

Comparison of Anchorage Efficiency of Orthodontic Mini-implant and Conventional Anchorage Reinforcement in Patients Requiring Maximum Orthodontic Anchorage: A Systematic Review and Meta-analysis

OBJECTIVE

To compare the clinical effectiveness of mini-implants (MIs) and conventional anchorage appliances used for orthodontic anchorage reinforcement in patients with class I or II malocclusion with bimaxillary protrusion.

MATERIALS AND METHODS

Literature search was conducted through PubMed, Embase, and Cochrane from inception to July 2018. The following Medical Subject Heading terms were used for the search string: "skeletal anchorage", "temporary anchorage devices", "miniscrew implant", "mini-implant", "micro-implant". Standardized mean difference (SMD) and 95% confidence interval (CI) of horizontal and vertical movements of teeth from baseline were used for comparison.

RESULTS

A total of 12 studies were included in the final analysis. MI group significantly lowered mesial movement of molars compared to conventional anchorage group (SMD = -1.48, 95% CI = -2.25 to -0.72; P = .0002). There was significantly higher retraction of incisors in the MI group than in the conventional group (SMD = -0.47 mm, 95% CI = -0.87 to -0.07; P = .02). No significant difference was seen in vertical movement of molars (SMD = -0.21 mm, 95% CI = -0.87 to 0.45; P = .52) and incisors (SMD = -0.30, 95% CI = -1.18 to 0.58; P = .5).

CONCLUSION

MIs seem to be more effective than the conventional anchorage devices in terms of minimizing unintended mesial movement of molars with maximum retraction of anterior teeth.