A new approach of splint-less orthognathic surgery using a personalized orthognathic surgical guide system: A preliminary study

The purpose of this study was to evaluate a personalized orthognathic surgical guide (POSG) system for bimaxillary surgery without the use of surgical splint. Ten patients with dentofacial deformities were enrolled. Surgeries were planned with the computer-aided surgical simulation method. The POSG system was designed for both maxillary and mandibular surgery. Each consisted of cutting guides and three-dimensionally (3D) printed custom titanium plates to guide the osteotomy and repositioning the bony segments without the use of the surgical splints. Finally, the outcome evaluation was completed by comparing planned outcomes with postoperative outcomes. All operations were successfully completed using the POSG system. The largest root-mean-square deviations were 0.74mm and 1.93° for the maxillary dental arch, 1.10mm and 2.82° for the mandibular arch, 0.83mm and 2.59° for the mandibular body, and 0.98mm and 2.45° for the proximal segments. The results of the study indicated that our POSG system is capable of accurately and effectively transferring the surgical plan without the use of surgical splint. A significant advantage is that the repositioning of the bony segments is independent to the mandibular autorotation, thus eliminates the potential problems associated with the surgical splint.

New approach to establish an object reference frame for dental arch in computer-aided surgical simulation

The purpose of this study was to develop a principal component analysis-based adaptive minimum Euclidean distances (PAMED) approach to establish an optimal object reference frame for symmetrical alignment of the dental arch during computer-aided surgical simulation (CASS). It was compared with our triangular methods and the standard principal component analysis (PCA) method. Thirty sets of maxillary digital models were used. Midsagittal and occlusal planes were ranked by three experienced evaluators based on their clinical judgment. The results showed that for the midsagittal plane, all three evaluators ranked "ideal" for all 30 models with the PAMED method, 28 with the triangular method, and at least 11 with the PCA method. For the occlusal plane, one evaluator ranked all 30 models "ideal" with both the PAMED and the PCA methods while the other two evaluators ranked all 30 models "ideal" with the triangular method. However, the differences among the three methods were minimal. In conclusion, our PAMED method is the most reliable and consistent approach for establishing the object reference frame for the dental arch in orthognathic surgical planning. The triangular method should be used with caution because it can be affected by dental arch asymmetry. The standard PCA method is not recommended.

Comparison of Upper Midline Incision With and Without Laparoscopic Assistance for Living-Donor Right Hepatectomy

BACKGROUND

Since minimally invasive procedures for living-donor right hepatectomy (LDRH) became popular in recent years, several studies comparing the outcomes of donors undergoing an upper midline incision (UMI) under laparoscopic assistance for LDRH with those undergoing the traditional open LDRH have been published. However, there are very few comparative studies of outcomes for a UMI for LDRH with and without laparoscopic-assistance. We designed the present study to compare the benefits and shortcomings of a UMI for LDRH with and without laparoscopic assistance.

METHODS

Forty-eight patients in our center were included in the study: group hybrid (n = 28) versus group UMI (n = 20). Their surgical outcomes, postoperative course, and cosmetic outcomes were studied from medical records.

RESULTS

No differences existed between the 2 groups regarding their baseline characteristics except that group Hybrid had more donors with positive hepatitis B core antibody. No difference was observed in operative time, graft weight, warm ischemia time, blood loss, incision length, liver and coagulation function test results, postoperative complications, or cosmetic parameters. No deaths occurred in both groups. The length of postoperative hospital stay was similar for both groups, but the hospital cost was significantly lower for group UMI than for group hybrid (6,906.7 ± 777.4 USD vs 7,643.3 ± 918.6 USD; P = .005).

CONCLUSIONS

An UMI without laparoscopic assistance can be considered as the first-line incision of choice for LDRH.

Sofosbuvir Monotherapy for Asymptomatic and Noncirrhotic Hepatitis C Infection in a Renal Retransplantation Recipient: A Case Report

Renal transplant recipients infected with hepatitis C virus (HCV) have a high risk of progressing to cirrhosis, end-stage liver diseases, and hepatocellular carcinoma. It is also considered as an independent risk for graft loss and is correlated with proteinuria, transplant glomerulopathy, HCV-associated glomerulonephritis, and chronic rejection. Previous therapy involving interferon alfa and ribavirin led to treatment complications, including toxicity, anemia, sepsis, and drug-drug interactions with calcineurin inhibitors, as well as reduced tolerability and efficacy. New direct-acting antiviral drugs simplify and shorten the treatment along with increasing tolerability and efficacy. Nevertheless, limited data and no specific regimen with direct-acting antiviral drugs have been described in the literature for renal transplant recipients with chronic HCV. We describe here the case of a 52-year-old Chinese man who diagnosed with chronic renal failure in 1997 and underwent renal transplantation the same year. In 2012, he was diagnosed with renal graft failure and again underwent hemodialysis. The patient then underwent his second renal transplantation and was administered an immunosuppressive cyclosporine-based regimen in 2015. During hemodialysis, he acquired asymptomatic genotype 1b HCV infection. Serologic test results reflecting liver cirrhosis were all negative, and ultrasound showed no abnormalities in the liver. The patient later required oral sofosbuvir monotherapy for 12 weeks after the second kidney transplantation. Curing HCV in renal transplant recipients is necessary. Although our treatment did not successfully result in a sustained virologic response, it suggests that genotype 1b HCV may have a poor response to a sofosbuvir monotherapy regimen. Specific and effective regimens for renal transplant recipients with HCV infection need to be confirmed in the future.

Competitive benzyl cation transfer and proton transfer: collision-induced mass spectrometric fragmentation of protonated N,N-dibenzylaniline

Collision-induced dissociation of protonated N,N-dibenzylaniline was investigated by electrospray tandem mass spectrometry. Various fragmentation pathways were dominated by benzyl cation and proton transfer. Benzyl cation transfers from the initial site (nitrogen) to benzylic phenyl or aniline phenyl ring. The benzyl cations transfer to the two different sites, and both result in the benzene loss combined with 1,3-H shift. In addition, after the benzyl cation transfers to the benzylic phenyl ring, 1,2-H shift and 1,4-H shift proceed competitively to trigger the diphenylmethane loss and aniline loss, respectively. Deuterium labeling experiments, substituent labeling experiments and density functional theory calculations were performed to support the proposed benzyl cation and proton transfer mechanism. Overall, this study enriches the knowledge of fragmentation mechanisms of protonated N-benzyl compounds. Copyright © 2017 John Wiley & Sons, Ltd.

Abstract P5-02-05: Biology and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014)

Background: Milestone studies showed that ultrasound (US) was an effective primary screening test for breast cancer both in the western world and in China [PMID: 26712110, 26715161, and 25668012]. Ultrasound has been officially designated to be the initial imaging test for breast cancer screening in Beijing and several other cities in China, due to its improved sensitivity in Chinese women who usually have denser breasts and develop breast cancer earlier than Caucasian counterparts. Study showed that it would take 40 years to screen each woman in the target age group once [PMID: 26808342].The mainstay modality of breast cancer screening in China is the hospital-based opportunistic screening among asymptomatic self-referred women. However, there is little data about the tumor biology and long-term survival of the US-detected non-palpable breast cancer (NPBC) in hospital-based Chinese population.

Methods: From January 2001 to December 2014, 3,786 asymptomatic women with positive (BI-RADS 4 and 5) initial screening US underwent biopsies in Peking Union Medical College Hospital, and 572 NPBC in 556 women were diagnosed. Women without dense breasts (defined as BI-RADS category C and D) also received screening mammography (MG) after physical examination and ultrasound. 788 patients with positive (BI-RADS 4 and 5) mammogram (MG) and normal US (BI-RADS 1, 2 and 3) underwent MG-guided biopsies and another 127 NPBC were diagnosed in 126 women. The clinicopathological features, treatment choice, 10-year disease-free survival (DFS) and overall survival (OS) were reviewed and compared between the US-detected and MG-detected NPBC. Prognostic factors of NPBC were identified.

Results: Overall, US could detect more invasive NPBC (83.4% vs 54.3%, p<0.001), lymph node positive cancer (19.1% vs 10.2%, p<0.001)and multifocal cancer (19.2% vs 6.3%, p<0.001). In invasive NPBC, US detected more low grade cancer (21.4% vs 10.2%, p=0.001), multifocal cancer (20.7% vs 2.9%, p<0.001), Her2 negative cancer (77.6% vs 62.3%, p=0.001) and larger tumor (pT1c+pT2, 53.3% vs 37.6%, p<0.001). There was no significant difference in immunophenotype/subtype, treatment methods, DFS or OS between US- and MG-NPBC among ductal carcinoma in situ (DCIS), invasive and all NPBC. For all NPBC and the US-NPBC, the common DFS-factors included pT, pN and p53 whereas OS-predictors were pN and immunophenotype/subtype.

Table 1. Kaplan-Meier estimates of DFS and OS between US-NPBC and MG-NPBC§.Patients (No.)10-year DFS (%)P value10-year OS (%)P valueAllUS-NPBC (572)90.60.73896.10.142 MG-NPBC (127)92.7 100.0 DCISUS-NPBC (94)100.00.060100.0- MG-NPBC (58)93.8 100.0 InvasiveUS-NPBC (478)88.60.68095.20.239 MG-NPBC (69)92.0 100.0 § Kaplan-Meier survival curves between each two subgroups would be displayed in the poster.

Conclusion: Compared to MG, US detected more invasive NPBC with positive lymph node in hospital-based asymptomatic self-referred Chinese women, who could achieve comparable 10-year DFS and OS as MG-detected NPBC. US could serve as the feasible initial imaging modality in hospital-based opportunistic screening Chinese women.

Citation Format: Yao R, Pan B, Zhu Q, Xu Q, Zhou Y, Zhang J, Mao F, You S, Lin Y, Shi J, Guan J, Wang X, Zhang Y, Zhang X, Shen S, Zhong Y, Xu Y, Liang Z, Jiang Y, Sun Q. Biology and long-term prognosis of screening detected non-palpable breast cancer by ultrasound in hospital-based Chinese population (2001-2014) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-02-05.

GC/MS-based metabolomic analysis of alleviated renal ischemia-reperfusion injury induced by remote ischemic preconditioning

OBJECTIVE

Dysfunctional metabolisms have contributed towards ischemia-reperfusion (I/R) injury. However, the role of remote ischemic preconditioning (RIP) in I/R injury is not well known. The present study showed alleviated I/R injury in kidneys treated with RIP.

MATERIALS AND METHODS

We utilized GC/MS-based metabolomics to characterize the variation of metabolomes.

RESULTS

Metabolic category using differential metabolites showed the lower percentage of amino acids in I/R group in comparison to RIP+I/R group, confirming the importance of amino acid metabolism in RIP-treated rat kidney. Further, pathway enrichment analysis showed alanine, aspartate and glutamate metabolism to be involved in the beneficial effects of RIP during renal I/R injury. Furthermore, another crucial enrichment pathway is biosynthesis of unsaturated fatty acids. Other vital metabolites detected in independent component analysis (ICA) analysis were d-glucose, lactic acid and cholesterol. The variation tendency of above-mentioned metabolites was overall consistent with the protective nature of RIP.

CONCLUSIONS

These findings elicited a viewpoint that metabolic strategy affected by RIP are linked to underlying mechanisms of RIP and highlighted the importance of metabolic strategy against I/R injury.

Mechanisms of OGT2115 inhibition of invasion and migration in KB oral cancer cells. Retracted

OBJECTIVE

The purpose of this study was to investigate the effect of the heparanase inhibitor OGT2115 on the tumorigenic properties of KB oral cancer cells.

MATERIALS AND METHODS

We treated KB cells with different concentrations of OGT2115. Then proliferation, invasion, and migration were detected using different assays. Cell cycle was explored using flow cytometry.

RESULTS

We found that the treatment inhibited proliferation, invasion, and migration in a dose-dependent manner. OGT2115 also increased the apoptosis of KB cells and blocked cell cycle in S-phase.

CONCLUSIONS

Our results support the use of the heparanase inhibitor OGT2115 to inhibit several tumorigenic activities of KB oral cancer cells.

miR-19a promotes colitis-associated colorectal cancer by regulating tumor necrosis factor alpha-induced protein 3-NF-κB feedback loops

Chronic inflammation is believed to have a crucial role in colon cancer development. MicroRNA (miRNA) deregulation is common in human colorectal cancers, but little is known regarding whether miRNA drives tumor progression by regulating inflammation. Here, we showed that miR-19a can promote colitis and colitis-associated colon cancer (CAC) development using a CAC mouse model and an acute colitis mouse model. Tumor necrosis factor-α (TNF-α) stimulation can increase miR-19a expression, and upregulated miR-19a can in turn activate nuclear factor (NF)-κB signaling and TNF-α production by targeting TNF alpha-induced protein 3 (TNFAIP3). miR-19a inhibition can also alleviate CAC in vivo. Moreover, the regulatory effects of miR-19a on TNFAIP3 and NF-κB signaling were confirmed using tumor samples from patients with colon cancer. These new findings demonstrate that miR-19a has a direct role in upregulating NF-κB signaling and that miR-19a has roles in inflammation and CAC.

GaN nano-pyramid arrays as an efficient photoelectrode for solar water splitting

A prototype photoelectrode has been fabricated using a GaN nano-pyramid array structure grown on a cost-effective Si (111) substrate, demonstrating a significant improvement in performance of solar-powered water splitting compared with any planar GaN photoelectrode. Such a nano-pyramid structure leads to enhanced optical absorption as a result of a multi-scattering process which can effectively produce a reduction in reflectance. A simulation based on a finite-difference time-domain approach indicates that the nano-pyramid architecture enables incident light to be concentrated within the nano-pyramids as a result of micro-cavity effects, further enhancing optical absorption. Furthermore, the shape of the nano-pyramid further facilitates the photo-generated carrier transportation by enhancing a hole-transfer efficiency. All these features as a result of the nano-pyramid configuration lead to a large photocurrent of 1 mA cm^-2 under an illumination density of 200 mW cm^-2, with a peak incident photon-to-current conversion efficiency of 46.5% at ∼365 nm, around the band edge emission wavelength of GaN. The results presented are expected to pave the way for the fabrication of GaN based photoelectrodes with a high energy conversion efficiency of solar powered water splitting.

Low nanomolar concentrations of Cucurbitacin-I induces G2/M phase arrest and apoptosis by perturbing redox homeostasis in gastric cancer cells in vitro and in vivo

Cucurbitacin-I (Cu-I, also known as Elatericin B or JSI-124) is developed to inhibit constitutive and abnormal activation of STAT3 in many cancers, demonstrating a potent anticancer activity by targeting disruption of STAT3 function. Here, we for the first time systematically studied the underlying molecular mechanisms of Cu-I-induced gastric cancer cell death both in vitro and in vivo. In our study, we show that Cu-I markedly inhibits gastric cancer cell growth by inducing G2/M phase cell cycle arrest and apoptosis at low nanomolar concentrations via a STAT3-independent mechanism. Notably, Cu-I significantly decreases intracellular GSH/GSSG ratio by inhibiting NRF2 pathway to break cellular redox homeostasis, and subsequently induces the expression of GADD45α in a p53-independent manner, and activates JNK/p38 MAPK signaling. Interestingly, Cu-I-induced GADD45α and JNK/p38 MAPK signaling form a positive feedback loop and can be reciprocally regulated by each other. Therefore, the present study provides new insights into the mechanisms of antitumor effects of Cu-I, supporting Cu-I as an attractive therapeutic drug in gastric cancer by modulating the redox balance.