Mid-term outcomes of microfragmented adipose tissue plus arthroscopic surgery for knee osteoarthritis: A randomized, active-control, multicenter clinical trial

BACKGROUND

Osteoarthritis (OA) is the most prevalent form of degenerative whole-joint disease. Before the final option of knee replacement, arthroscopic surgery was the most widely used joint-preserving surgical treatment. Emerging regenerative therapies, such as those involving platelet-rich plasma, mesenchymal stem cells, and microfragmented adipose tissue (MFAT), have been pushed to the forefront of treatment to prevent the progression of OA. Currently, MFAT has been successfully applied to treat different types of orthopedic diseases.

AIM

To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA (KOA).

METHODS

A randomized, multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang, China. Overall, 302 patients diagnosed with KOA (Kellgren-Lawrence grades 2-3) were randomized to the MFAT group (n = 151, were administered MFAT following arthroscopic surgery), or the control group (n = 151, were administered hyaluronic acid following arthroscopic surgery). The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the visual analog scale (VAS) score, the Lequesne index score, the Whole-Organ Magnetic Resonance Imaging Score (WORMS), and safety over a 24-mo period from baseline.

RESULTS

The changes in the WOMAC score (including the three subscale scores), VAS pain score, and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups, as well as when comparing values at the posttreatment visit and those at baseline (P < 0.001). The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group (P < 0.05). Furthermore, the WOMAC stiffness score, WOMAC function score, and Lequesne index score differed significantly between the groups at 12 and 24 mo (P < 0.05). However, no significant between-group differences were observed in the WORMS at 24 mo (P = 0.367). No serious adverse events occurred in both groups.

CONCLUSION

The MFAT injection combined with arthroscopic surgery treatment group showed better mid-term clinical outcomes compared to the control group, suggesting its efficacy as a therapeutic approach for patients with KOA.

Comparison between zero-profile and cage plate devices in the treatment of single-level cervical spondylopathy

OBJECTIVE

To compare the new zero-profile (Zero-P) fusion cage with regular cage and plate (CP) in the treatment of anterior cervical single-level cervical degenerative diseases.

METHODS

Patients operated from January 2013 to August 2018 were enrolled. They were divided into the Zero-P group (n = 74 cases) and CP groups (n = 116 cases). Follow-up assessment was at 1, 3, 12, and 24 months after surgery, including the incidence of dysphagia, visual analogue scale (VAS) score, Japanese orthopaedic association (JOA)score, C2-C7 Cobb angle, intervertebral disc height (IDH) and adjacent joint degeneration.

RESULTS

The operation time and blood loss of patients in Zero-P group were less than those in the CP group, and there was no difference in hospitalization time. All 190 patients were followed up for 24 to 72 months, with an average of 35.29 months. In terms of clinical outcomes, vas and JOA scores of the two groups were significantly improved at one month and the last follow-up. The incidence of dysphagia in the Zero-P group was lower than that in the CP group. On radiological effects, Cobb angle and IDH showed significant correction in both groups, but the degeneration rate of adjacent joints in the Zero-P group was lower than the CP group.

CONCLUSIONS

In ACDF, the clinical and radiological results of Zero-P and CP devices are satisfactory, but Zero-P cage may be superior in operation time, blood loss, the incidence of dysphagia and adjacent joint degeneration.

An Immune-Related Long Non-Coding RNA Signature to Predict the Prognosis of Ewing's Sarcoma Based on a Machine Learning Iterative Lasso Regression

The aim of this study was to construct a new immune-associated long non-coding RNA (lncRNA) signature to predict the prognosis of Ewing sarcoma (ES) and explore its molecular mechanisms. We downloaded transcriptome and clinical prognosis data from the Gene Expression Omnibus (GSE17679, which included 88 ES samples and 18 matched normal skeletal muscle samples), and used it as a training set to identify immune-related lncRNAs with different expression levels in ES. Univariable Cox regression was used to screen immune-related lncRNAs related to ES prognosis, and an immune-related lncRNA signature was constructed based on machine learning iterative lasso regression. An external verification set was used to confirm the predictive ability of the signature. Clinical feature subgroup analysis was used to explore whether the signature was an independent prognostic factor. In addition, CIBERSORT was used to explore immune cell infiltration in the high- and low-risk groups, and to analyze the correlations between the lncRNA signature and immune cell levels. Gene set enrichment and variation analyses were used to explore the possible regulatory mechanisms of the immune-related lncRNAs in ES. We also analyzed the expression of 17 common immunotherapy targets in the high- and low-risk groups to identify any that may be regulated by immune-related lncRNAs. We screened 35 immune-related lncRNAs by univariate Cox regression. Based on this, an immune-related 11-lncRNA signature was generated by machine learning iterative lasso regression. Analysis of the external validation set confirmed its high predictive ability. DPP10 antisense RNA 3 was negatively correlated with resting dendritic cell, neutrophil, and γδ T cell infiltration, and long intergenic non-protein coding RNA 1398 was positively correlated with resting dendritic cells and M2 macrophages. These lncRNAs may affect ES prognosis by regulating GSE17721_CTRL_VS_PAM3CSK4_12H_BMDC_UP, GSE2770_IL4_ACT_VS_ACT_CD4_TCELL_48H_UP, GSE29615_CTRL_VS_DAY3_ LAIV_IFLU_VACCINE_PBMC_UP, complement signaling, interleukin 2-signal transducer and activator of transcription 5 signaling, and protein secretion. The immune-related 11-lncRNA signature may also have regulatory effects on the immunotherapy targets CD40 molecule, CD70 molecule, and CD276 molecule. In conclusion, we constructed a new immune-related 11-lncRNA signature that can stratify the prognoses of patients with ES.

Development of a Machine Learning-Based Autophagy-Related lncRNA Signature to Improve Prognosis Prediction in Osteosarcoma Patients

Background

Osteosarcoma is a frequent bone malignancy in children and young adults. Despite the availability of some prognostic biomarkers, most of them fail to accurately predict prognosis in osteosarcoma patients. In this study, we used bioinformatics tools and machine learning algorithms to establish an autophagy-related long non-coding RNA (lncRNA) signature to predict the prognosis of osteosarcoma patients.

Methods

We obtained expression and clinical data from osteosarcoma patients in the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) and Gene Expression Omnibus (GEO) databases. We acquired an autophagy gene list from the Human Autophagy Database (HADb) and identified autophagy-related lncRNAs by co-expression analyses. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of the autophagy-related lncRNAs were conducted. Univariate and multivariate Cox regression analyses were performed to assess the prognostic value of the autophagy-related lncRNA signature and validate the relationship between the signature and osteosarcoma patient survival in an independent cohort. We also investigated the relationship between the signature and immune cell infiltration.

Results

We initially identified 69 autophagy-related lncRNAs, 13 of which were significant predictors of overall survival in osteosarcoma patients. Kaplan-Meier analyses revealed that the 13 autophagy-related lncRNAs could stratify patients based on their outcomes. Receiver operating characteristic curve analyses confirmed the superior prognostic value of the lncRNA signature compared to clinically used prognostic biomarkers. Importantly, the autophagy-related lncRNA signature predicted patient prognosis independently of clinicopathological characteristics. Furthermore, we found that the expression levels of the autophagy-related lncRNA signature were significantly associated with the infiltration levels of different immune cell subsets, including T cells, NK cells, and dendritic cells.

Conclusion

The autophagy-related lncRNA signature established here is an independent and robust predictor of osteosarcoma patient survival. Our findings also suggest that the expression of these 13 autophagy-related lncRNAs may promote osteosarcoma progression by regulating immune cell infiltration in the tumor microenvironment.

Screening of osteoarthritis diagnostic markers based on immune-related genes and immune infiltration

Osteoarthritis (OA) is a chronic degenerative disease of the bone and joints. Immune-related genes and immune cell infiltration are important in OA development. We analyzed immune-related genes and immune infiltrates to identify OA diagnostic markers. The datasets GSE51588, GSE55235, GSE55457, GSE82107, and GSE114007 were downloaded from the Gene Expression Omnibus database. First, R software was used to identify differentially expressed genes (DEGs) and differentially expressed immune-related genes (DEIRGs), and functional correlation analysis was conducted. Second, CIBERSORT was used to evaluate infiltration of immune cells in OA tissue. Finally, the least absolute shrinkage and selection operator logistic regression algorithm and support vector machine-recurrent feature elimination algorithm were used to screen and verify diagnostic markers of OA. A total of 711 DEGs and 270 DEIRGs were identified in this study. Functional enrichment analysis showed that the DEGs and DEIRGs are closely related to cellular calcium ion homeostasis, ion channel complexes, chemokine signaling pathways, and JAK-STAT signaling pathways. Differential analysis of immune cell infiltration showed that M1 macrophage infiltration was increased but that mast cell and neutrophil infiltration were decreased in OA samples. The machine learning algorithm cross-identified 15 biomarkers (BTC, PSMD8, TLR3, IL7, APOD, CIITA, IFIH1, CDC42, FGF9, TNFAIP3, CX3CR1, ERAP2, SEMA3D, MPO, and plasma cells). According to pass validation, all 15 biomarkers had high diagnostic efficacy (AUC > 0.7), and the diagnostic efficiency was higher when the 15 biomarkers were fitted into one variable (AUC = 0.758). We developed 15 biomarkers for OA diagnosis. The findings provide a new understanding of the molecular mechanism of OA from the perspective of immunology.

Development of a novel immune-related genes prognostic signature for osteosarcoma

Immune-related genes (IRGs) are responsible for osteosarcoma (OS) initiation and development. We aimed to develop an optimal IRGs-based signature to assess of OS prognosis. Sample gene expression profiles and clinical information were downloaded from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) and Genotype-Tissue Expression (GTEx) databases. IRGs were obtained from the ImmPort database. R software was used to screen differentially expressed IRGs (DEIRGs) and functional correlation analysis. DEIRGs were analyzed by univariate Cox regression and iterative LASSO Cox regression analysis to develop an optimal prognostic signature, and the signature was further verified by independent cohort (GSE39055) and clinical correlation analysis. The analyses yielded 604 DEIRGs and 10 hub IRGs. A prognostic signature consisting of 13 IRGs was constructed, which strikingly correlated with OS overall survival and distant metastasis (p < 0.05, p < 0.01), and clinical subgroup showed that the signature’s prognostic ability was independent of clinicopathological factors. Univariate and multivariate Cox regression analyses also supported its prognostic value. In conclusion, we developed an IRGs signature that is a prognostic indicator in OS patients, and the signature might serve as potential prognostic indicator to identify outcome of OS and facilitate personalized management of the high-risk patients.

In Situ Measurement of Vacuum Window Birefringence using 25Mg+ Fluorescence

Accurate control of the polarization states of laser light is important in precision measurement experiments. In experiments involving the use of a vacuum environment, the stress-induced birefringence effect of the vacuum windows will affect the polarization states of laser light inside the vacuum system, and it is very difficult to measure and optimize the polarization states of the laser light in situ. The purpose of this protocol is to demonstrate how to optimize the polarization states of the laser light based on the fluorescence of ions in the vacuum system, and how to calculate the birefringence of vacuum windows based on azimuthal angles of external wave plates with Mueller matrix. The fluorescence of ²⁵Mg⁺ ions induced by laser light that is resonant with the transition of |3²P3/2,F = 4, mF = 4 → |3²S1/2,F = 3, mF = 3 is sensitive to the polarization state of the laser light, and maximum fluorescence will be observed with pure circularly polarized light. A combination of half-wave plate (HWP) and quarter-wave plate (QWP) can achieve arbitrary phase retardation and is used for compensating the birefringence of the vacuum window. In this experiment, the polarization state of the laser light is optimized based on the fluorescence of ²⁵Mg⁺ ion with a pair of HWP and QWP outside the vacuum chamber. By adjusting the azimuthal angles of the HWP and QWP to obtain maximum ion fluorescence, one can obtain a pure circularly polarized light inside the vacuum chamber. With the information on the azimuthal angles of the external HWP and QWP, the birefringence of the vacuum window can be determined.

GRB10 and E2F3 as Diagnostic Markers of Osteoarthritis and Their Correlation with Immune Infiltration

This study aimed to find potential diagnostic markers for osteoarthritis (OA) and analyze the role of immune cells infiltration in this pathology. We used OA datasets from the Gene Expression Omnibus database. First, R software was used to identify differentially expressed genes (DEGs) and perform functional correlation analysis. Then least absolute shrinkage and selection operator (LASSO) logistic regression and support vector machine-recursive feature elimination algorithms were used to screen and verify the diagnostic markers of OA. Finally, CIBERSORT was used to evaluate the infiltration of immune cells in OA tissues, and the correlation between diagnostic markers and infiltrating immune cells was analyzed. A total of 458 DEGs were screened in this study. GRB10 and E2F3 (AUC = 0.962) were identified as diagnostic markers of OA. Immune cell infiltration analysis found that resting mast cells, T regulatory cells, CD4 memory resting T cells, activated NK cells, and eosinophils may be involved in the OA process. In addition, GRB10 was correlated with NK resting cells, naive CD4 + T cells, and M1 macrophages, while E2F3 was correlated with resting mast cells. In conclusion, GRB10 and E2F3 can be used as diagnostic markers of osteoarthritis, and immune cell infiltration plays an important role in the occurrence and progression of OA.

A simple method for in situ measurement of vacuum window birefringence

We present a simple method to measure the degrees of circular polarization (DoCP) of laser light inside a vacuum chamber and the birefringence of a vacuum window by detecting the fluorescence emitted by Doppler cooled ions in an ion trap. Imperfect laser polarization will cause ions to be pumped to the dark state which will decrease the fluorescence rates of the ions. With a simulation based on the rate equations of the relevant energy levels of ²⁵Mg⁺ ions, we find that the fluorescence rate is sensitive to the DoCP of the laser. Based on the simulation result, we present a new method to optimize the DoCP of the laser inside the vacuum chamber by adjusting fast axis azimuthal angles of a half-wave plate and a quarter-wave plate outside the vacuum chamber. The laser light is optimized to be circularly polarized with an uncertainty of the DoCP of 7.8 × 10^-5. With the obtained polarization information on both sides of the vacuum window and treating the vacuum window as an unknown wave plate, the phase delay and the fast axis azimuthal angle of the vacuum window can be determined in the form of Mueller matrix. The phase delay is determined to be 197.60(39)°, and the fast axis azimuthal angle is determined to be 104.00(5)°.

A modified model of helical resonator with predictable loaded resonant frequency and Q-factor

High voltage radio frequency (RF) supply is a critical part in an ion trapping system. The RF supply should have high Q-factor and relatively high driving frequency. A frequently used RF supply for an ion trap system is a helical resonator. In certain applications, it is advantageous to have a predictable resonant frequency and Q-factor when the helical resonator is connected to a capacitive load. We develop a model to describe the behavior of a helical resonator with capacitive load. With this model, we can correctly predict the loaded resonant frequency and the loaded Q-factor. To test our prediction, we construct a helical resonator, and measure its resonant frequencies and Q-factors under different capacitive loads. The experimental results agree with our prediction.

A long-term frequency stabilized deep ultraviolet laser for Mg+ ions trapping experiments

As many precision laser spectroscopy experiments require frequency stabilized lasers, development of long-term stabilized lasers is of great interest. In this work, we report long-term frequency stabilization of a 280 nm deep ultraviolet laser to a high precision wavemeter with digital servo control such that the long-term drift of the laser frequency was greatly reduced. Long-term laser frequency drift was measured with a fiber frequency comb system over 8 h. After locking, the maximum drift rate of the 280 nm laser was lowered from 576 MHz/h to 6.4 MHz/h. With proper environment control of the wavemeter, the maximum drift rate of the 280 nm laser was further lowered to less than 480 kHz/h. The locked laser system was successfully used in a Mg(+) ions trapping experiment, which was also discussed in this work.

Preventive vertebroplasty for adjacent vertebral bodies: a good solution to reduce adjacent vertebral fracture after percutaneous vertebroplasty

BACKGROUND AND PURPOSE

Adjacent VCF frequently occurs after percutaneous vertebroplasty. Our aim was to evaluate PrVP in the prevention of PVNO-adjacent VCF.

MATERIALS AND METHODS

Radiographs of 68 patients who initially presented with a single-level unhealed fracture and underwent vertebroplasty were retrospectively reviewed for the occurrence of PVNO fracture. Patients in the nonpreventive group (n = 33) underwent TVP only for a vertebra with an unhealed fracture. The preventive group (n = 35) underwent PrVP combined with TVP. We injected bone cement into the caudal part of the superior adjacent vertebra and the cephalic part of the inferior adjacent vertebra to perform PrVP.

RESULTS

The incidences of PVNO fracture in adjacent vertebra next to a vertebra cemented at the patient's first vertebroplasty (within 6 months: 24% versus 3%, P = .012; within 1 year: 30% versus 3%, P = .006; >4 years: 39% versus 3%, P = .006) markedly decreased in the preventive group compared with the nonpreventive group. PVNO fracture was found in 26% of vertebrae adjacent to the first TVP level in the nonpreventive group and in 2% of vertebrae adjacent to a PrVP level in the preventive group after inclusion of all PrVP procedures. Approximately 33% of patients in the nonpreventive group underwent repeat vertebroplasty, mainly due to adjacent fractures. Only 3% of patients in the preventive group underwent repeated procedures. None of the vertebrae cemented for PrVP or TVP developed PVNO refracture.

CONCLUSIONS

Preventive vertebroplasty for the adjacent vertebra combined with TVP for the fractured vertebra is effective in the prevention of propagation of PVNO adjacent fractures, thus reducing the necessity of multiple repeat vertebroplasty procedures.

Evaluation of Free Flaps Transferred by Microvascular Anastomosis in Oral and Maxillofacial Surgery

The authors discuss indications for the use of microvascular free flaps transferred to the oral and maxillofacial region. A series of 139 cases, involving 145 free flaps, is reported over a three year period. The overall success rate for all types of flaps was 89.3%. Advantages and disadvantages of the use of various flaps are presented and suggestions are offered to avoid complications.

[A primary study on the relationship between condyle position and anterior distraction for cross bite caused by cleft lip and palate]

OBJECTIVE

To evaluate the changes of the position of the mandibular condyle in cleft lip and palate patients with secondary bony cross-bite deformity after early orthodontic treatment with extraoral bow and facial mask.

METHODS

The TMJ topograph 6 months before and after treatment was investigated in 8 patients. The width of the anterior,superior and posterior space of the TMJ was compared prior to and post treatment.

RESULTS

The results showed that there was no significant difference in the width of the three spaces of the TMJ before and after treatment.

CONCLUSION

The position of the mandibular condyle had no significant change after maxillary anterior distraction with extraoral bow and facial mask.

[Primary study on speech training of palatalized misarticulation]

OBJECTIVE

In this paper, differences in 10 palatalized misarticulation patients between pre-and post-speech training were reported to discuss the training methods of palatalized misarticulation.

METHODS

10 palatalized misarticulation patients (6 male, 4 female) with the age of 4-14 years were included in the study. All the patients had undergone systematic speech therapy,and their speech intelligibilities were analyzed.

RESULTS

All patients' speech intelligibilities after training were significantly higher than those before training. /s/, /z/, /c/, /d/, /t/, /zh/, /ch/, /sh/, /j/, /q/ and /x/ were often involved.

CONCLUSION

Palatalized misarticulation was caused by abnormal palato-lingual contact which leads to decreasement of speech intelligibility. Speech training is the only method to correct the wrong articulation position and articulation method. The key of training methods for palatalized misarticulation is to plane the dorsum and release the tongue's retroflex.

[Assessment of velopharyngeal function in normal speech by CT]

OBJECTIVE

To find an objective method to assess velopharyngeal function by CT.

METHODS

Three dimensional conformation of the velopharyngeal orifice of 30 subjects with normal speech at rest and /i:/ position were observed and analyzed. The linear distance and area of velopharyngeal orifice were measured and analyzed statistically.

RESULTS

The average minimal area of velopharyngeal orifice at/i:/ position was 11.92+/-11.73 mm(2). The physical RVPI was 4.03+/-4.03%. Coronary closure was the most common type of velopharyngeal contraction which accounted for 50%, semi-ring type being 30%, and ring type being 20%. No sagittal closure were seen in this study. There were 70% subjects whose position of velopharyngeal closure was at the level of the first cervical vertebra, 26.7% above the level and 3.3% below it. The arrange of velopharyngeal closure was 9-12 mm in 83.4% subjects, and 3-6mm in 16.6%.

CONCLUSION

As a method of assessing velopharyngeal function, CT can not only observe the conformation of velopharyngeal orifice in three dimensions, but also quantitatively analyze the velopharyngeal function.

Image evaluation of suprazygomatic masticator space lesions

In order to understand lesions involving the suprazygomatic masticator space (SZMS) demonstrated on computered tomography (CT) or magnetic resonance (MR) images, we collected 45 cases of lesions in SZMS. There were hematomas in 26 cases, tumors in 16 cases, and abscesses in 3 cases. The location of these lesions in compartments of the SZMS and adjacent structures was analyzed. Most commonly hematoma was found in the deep loose connective tissue (80.8%), followed by the superficial dense connective tissue (61.5%). Only 2 SZMS hematoma involved the superficial fat pad. Five patients had air accumulation in the SZMS, and all were in the deep fat pad and with maxillary sinus fracture. Of the sixteen cases which were tumors, 12 were extended from adjacent structures, and four were primary tumor. In cases of tumor, compartments of SZMS involved most frequently were temporal muscles (15 of 16 cases), followed by deep fat pad (8 of 16 cases). The connective tissue layer of SZMS is a communication pathway for superficial spread of infection, hematoma, or tumor invasion to or from the scalp and face. Compartments of deep fat pad and temporal muscle are also pathways for the spread of disease to or from the face, intracranium and orbit. The primary tumors in infratemporal fossa and SZMS are rare. Malignant tumors in SZMS usually come from surrounding spaces.

[Early face mask treatment for maxillary hyperplasia in patients with cleft lip and Palate]

OBJECTIVE: Early interfering orthodontics were used to treat maxillary hyperplasia by face mask and extra-oral bow technique in teenages.The position changes of maxilla after orthodontic treatment were evaluated.METHODS:The cephlometric variables before and after treatment were measured.Variables after treatment were compared with normal values in children with same ages,and changes of the maxillary position was determind.RESULTS:The position of the maxilla after orthopedics was significantly advanced (P<0.001),but there was still difference from normal values.CONCLUSION:In the peroid of mixed dentition of patients with cleft lip and palate,early orthodontics on maxillary hyperplasia could stimulate maxillary development and growth,remove or improve crossbite,extra-oral bow and face mask were efficient tools for this kind of patients.

[The normal people's parameters of the velopharyngeal incompetence(VPI) by cephalometric analysis]

OBJECTIVE:To estimate velopharyngeal incompetence(VPI)in patients with cleft lip and palate,we seek for the normal people's parameters of VPI. METHODS:Studying on 222 normal people with VPI by cephalometric analysis,the parameters of the normal people have been set up.RESULTS: There was remarkable correlationship between the rate of velopharyngeal sagital restriction by cephalometric analysis and the rate of VPI by nasopharyngeal endoscope.CONCLUSION:Cephalometric analysis is useful to estimate the function of velopharyngeal closure and mobility of the soft palate.

[Presurgical infant orthopedics in complete bilateral cleft lip and palate reconstruction]

OBJECTIVE:This study want to effects on using intraoral-appliance treatment of complete bilateral left lip and Palate in clinic.METHODS:Using Lisson's method preliminary evaluated to effect of presurgical infant orthopedics complete bilateral cleft lip and palate.A sample of 4 cases of 18 weeks infant complete bilateral cleft lip and palate.2 of they are males, others are females.All of they had received presurgical infant orthopedics,Using intraoral appliance. comparison of before and after cast analysis.Evaluate anteiro posteior I, tranverse,oblique degree of the lateral segment, pretrusion premaxilla position change.RESULTS:Every patients after orthopedics treatment had retracted premaxilla come back,corrected of oblique of premaxilla,had lateral segments growth equally on both side,their inclination should be similar.CONCLUSION:Intraoral-appliance can successfully improved malarrangement maxilla of bilateral cleft lip and palate.

[Observation of the biodegradation of domestic poly-DL-lactic acid plates in vivo]

OBJECTIVE:To analyze the degradation and related factors of domestic poly-DL-lactic acid(PDLLA) plates in vivo. METHODS: The artifical transverse fractures in mandibular bodies of dogs were created and internal fixed with domestic PDLLA plates as experimental group,the implanted PDLLA plates in femurs as control.A certain time after the operation,the plates in fractured and implanted regions were collected and undertaken macroscopy and scanning electromicroscopy(SEM),meanwhile the fracture-healing status was evaluated. RESULTS: With time going on,the surface of domestic PDLLA plates y and density of micro-holes among poly-DL-lactic acid molecules in the PDLLA plates increased gradually.16-20 weeks Domestic PDLLA plates can be gradually biodegradation in vivo,in which it is correspondent with and accelerative the fracture-healing process.

[Observation in vivo histological response induced by imlplanted domestic poly-DL-lactic acid plates]

OBJECTIVE:To analyze the histological response and biocompatibility to implanted domestic PDLLA plates in vivo METHODS:Bilateral artificial fractures were created in mandibular bodies in dog and internal fixed with domestic PDLLA plate,TM plate respectively;meanwhile,a domestic PDLLA plate was imlplanted in femur.The interfacial soft tissue around the plates were collected and performed histological study RESULTS:All the skin wound healed well without abscess and fistula formation. From 2 to 4 weeks after the operation,the inflmmatory granulomatous response around the intenal fixation PDLLA plates was more serious than that of the control,in which more macrophages,plasmocytes and less lymphocytes,mononuclear cells infiltrated CONCLUSION:Domestic PDLLA plate is an inert internal fixation material with good biocompatibility, which induced a non-speciflc foreign reaction

[A comparison of the effects of 180kv X-ray radiation and cobalt-60 radiation on the jaws of the guinea pigs]

OBJECTIVE: Study of the effects of 180kv x-ray and cobalt-60 radiation on jaws and enhance the understanding of pathology of osteroradionecrosis of jaws(ORNJ).METHODS: 128 guinea pigs were grouped according to different irradiation sources and doses.Fractioned radiation from both sources was delivered in right mandible.The teeth extractions were conducted one week prior to radiation and 1,3,5 months after radiation respectively.Following radiation,the guinea pigs were examined by gross observation, x-ray film and histopathological examination at regular interval. RESULTS: Bone resorption occured within 1 month after irradiation as result of osteoblast inhibition and osteoclast activation.From 2 to 4 month afterwards,the number of osteocytes reduced and pyknosis, empty lacunae as well as obliteration of small vessels in periodontal membrane were commonly seen.The teeth extractions conducted at 3 months,5 months after radiation lead to ORNJ in 7 amimals (14.6%).CONCLUSION: 180kv x-ray radiation was far more damaging to jaws than cobalt-60 radiation.The dental extraction is an important factor inducint the development of ORNJ.

Experimental study of radiation effect on the mandibular microvasculature of the guinea pig

OBJECTIVE

This experimental study was performed to explore the intraosseous microvascular alterations in the irradiated mandible and to increase understanding of the pathogenesis of osteoradionecrosis.

METHODS

One hundred twenty-eight guinea pigs were grouped according to different radiation sources and dosages. Fractioned radiation was delivered to the right mandibles. Dental extractions were conducted at 1, 3, and 5 months respectively, after radiation. One month later, the animals were examined by means of gross observation, histopathology, and microvascular corrosion castings.

RESULTS

Histologic evaluation showed bone absorption within 2 months following radiation. Four months later, the number of osteocytes decreased and pyknosis and empty lacunae were commonly seen. The casting specimens revealed under scanning electron microscopy that capillary disconnection and obliteration with subsequent vein shrinkage aggravated over time. In the nonhealing dental extraction site, a large-scale vascular network defect presented with focal capillary proliferation around.

CONCLUSIONS

The capillary is the part most vulnerable to the damage caused by radiation in the vascular system of the mandible. On the basis of "hypovascular, hypoxic, hypocellular" structure, local microcirculation failure induced by the trauma-repairing process leads to occurrence of osteoradionecrosis of jaws.

[Cephalometric analysis of maxillary development in adult unoperated cleft palate patients]

OBJECTIVE: Analysis of maxillary development in adult unoperated cleft palate patients.METHODS:Lateral cephalometric radiographs of 37 case of adult unoperated cleft palate (UCP) patients were analyzed with computerized aided image system, 20 normal adults were as a control group.RESULTS: Showed that maxillary anteroposterior distance of UCP group is shorter than normal control group (P<0.05) and there is no significant difference on superoinferior distance of jaw between the UCY group and normal control group (P>0.05).CONCLUSION:The cleft palate intrinsic deformities can interfere maxillarv normal development.

[Evaluation of speech aid's function with air flow pressure techniques]

OBJECTIVE:To evaluated of speech aid's function with air flow pressure techniques. METHODS: The study group contained 12 patients with cleft palate,submucous cleft palate and congenital velopharyngeal insufficiency who had been found to have VPI(velopharyngeal insufficiciency) and hypernasal speech and were scheduled for speech aid. RESULTS: It was confirmed that study was to assess the relationship between oral-nasal resonance with and without the speech aid. CONCLUSION: The speech aid be able to improve the velopharyngeal function in some VPI patients,also it is useful clinical results for the speech therapiist.

[A study on speech training methods for patients following cleft palate repair]

OBJECTIVE:This study is to improve speech articulations of patients following cleft palate repair. METHODS: 20 cases were treated with systemic speech trainning. The methods included testing speech articulations of pre-and post-training blowing and systemic speech training whose program was consonant (first step), syllable (second), word (third), sentence (forth), and (fifth). RESULTS: It is showed that their articulations improved from 48.1% to 97.1% on average,and,the improvement in speech was highly significant statistically(P<0.0001).The younger the patient was,the shorter the training circle was. CONCLUSION: Speech training can correct habit of compensatory pathologic articulation and improve articluation of patient following cleft palate repair.

[The advanced studies on surgical treatment about the patients of TMJ ankylosis and OSAS]

OBJECTIVE: Through the treatment on the 10 patients suffered TMJ ankylosis and OSAS,by means of the TMJ reconstruction combining orthognathic surgery,it is demonstrated that the treatment on the patients must include relieve the TMJ anklosis,correct the maxillofacial deformitis and specially enlarge upper airway space.

[The pre-postoperative polysomnographic evaluation on the patients of TMJ ankylosis with OSAS]

Passing by the comparative studies on the polysomnogram of the patients of TMJ ankylosis with OSAS pre-and-postoperation,the result showed the patients' AI (Apnea Index;AI) has been decreasing,SaO(2) during sleep get to rise,and the method combining TMJ reconstruction and orthognathic surgery is effective to the patients.

[Cephalometric analysis in the patients of TMJ ankylosis with OSAS: Skeletal morphology]

By cephalometric analysis of 18 normal men and 12 men who got TMJ ankylosis with obstructive sleep apnea syndrome(OSAS),the authors reported that there were cephalometric characteristics in the patients:the craniomaxillofacial bones displacement posteriorly and superiorly,and demonstrated that it is key to advance the patients' jaws and enlarge the upper airway space.

[Cephalometric analysis in the patients of TMJ ankylosis with OSAS: Soft tissue morphology]

By cephalometric analysis of 18 normal men and 12 men who got TMJ ankylosis with obstructive sleep apnea syndrome(OSAS),the authors reported that there were cephalometric characteristics in the patients:the posterior airway space(PAS) decreased(P<0.001),and the rate of (TA+SPA)/OPA remarkably increased(P<0.001),so the two parameters are significant for the diagnosis and treatment of the patients.

[The pre-and-postoperative cephalometric evaluation on the patients of TMJ ankylosis with OSAS]

After taken the comparative studies on the cephalometric analysis of the patients of TMJ ankyolsis with OSAS pre-and-post operation,the authors demonstrated the method combining TMJ reconstruction and orthognathic surgery is responsible to the patients.

[Quantitative study of velopharyngeal function post-palatoplasty]

The computer of nasopharyngeal fiberscope(NPF) for quantitative analysis was carried out to assess the palate articulation of 43 subjects,and normal articulation of 60 subjects.The rest,/a/,/s/and /m/ articulation of NPF pictures were calculated for veloparyngreal function via computer.

[Establishment and clinical application of Chinese language clear degree]

This study was established the Chinese language of clear degree.The subjects of this study consisted of 50 patients with postoperative of cleft lip and palate,congenital velopharyngeal incompetence,and 30 control group were normal articulation of persons.The results of this study may be helpful for further clinic of the cleft lip and palate patients of speech therapeutics.

[The treatment of unilateral true ankylosis of TMJ with maxillomandibular deformities]

The authors described a surgical procedure for the treatment of unilateral true ankylosis of TMJ with maxillomandibular deformities.The surgery included arthroplasty and Le Fort I maxillary osteotomy in one or two stages.It successfully not only restore the stomatognathic function with a maximum mouth opening in normal range,but also corrected malpositioned maxilla and mandible normal anatomic position.Postoperative orthodontic anatomic position.Postoperative orthodontic treatment was also performed for the improvement of masticatory function.The indications of the surgical procedure,and intraoperative precautions are discussed.

[Reconstruction of post-traumatic maxillofacial deformity: Analysis of 100 cases]

This paper collects 100 cases with post-traumatic maxillofacial deformity.The types of deformity may be involved by order to concave appearance restricted opening of jaw,disturbance of occlusion,mimetic paralysis,scar,etc.The author advocate the treatment must be paid attention both appearance and function.Recently,we have used the vascularized flap,coronary incision,orthognathic surgery and rigid internal fixation in these cases,and have gotten better result than past.This paper emphasizes that we should pay attention to emergency treatment to reduce the occur of post-traumatic deformity.

[One-stage surgical procedure of adult cleft palate with dentofacial deformity]

2 cases with primary adult cleft palate combining severe dentofacial deformities were undergone one-stage procedure of modified Le Fort I segmental osteotomy and Furlow's double reserving Z plasty,and with with satisfactory clinical effectiveness.Follow-up results show that the one-stage procedure is not only reducing treatment time and period,but also correcting velopharyngeal function.

[Orthognathic surgery of dentofacial deformities post surgerical repairing of cleft palate and lip.]

10 cases with maxillary development limited post surgical repairing of cleft palate and lip were undergone modified Le Fort I segmental osteotomy,that is,put the maxilla forward without velopharyngeal function change and oro-nasal fistula.By Computer Aided Simulation System for orthognathic surgery(CASSOS),analysis of dental pulp,evaluation of velopharyngeal function,compacting profile pre-to-post operation, authors described that surgical procedure has the satisfactory effectiveness.

[Evaluation of velopharyngeal function after later surgical repair of cleft palate. ]

This study detected 60 cases of patients of later surgical cleft palate repairing with different operative procedures,based on nasopharyngeal fiberscope and image processing detective system of nasopharyngeal function.They were divided into two groups,30 cases with Furlow's double reversing Z plasty,and others with traditional palatoplasty.The results were as follows:the type of velopharyngeal closure with later palatoplasty mainly were circus,semi-circus,and the rate of operative success only was 46.6%,which was lower than other reports.Author described that compensation of lateral and posterior pharyngeal wall made the type of velopharyngeal closure.The elder the age,the more the compensation is.For the late cleft palate repair,although the variable surgical procedure made a condition for speech improvement, patients with later cleft palate repair still can't improve their phonation.

[The study of assessing methods for velopharyngeal function in patients with operated cleft palate]

This paper describes the study and quantitative analysis of velopharyngeal function in 103 patients with operated cleft palate using NPF,vedio-camera system and computer.The percentange of semi-circluar and circular closure patterns after surgery was distinct higher in VPI group than in VPC group,but coronary closure pattern was significant lower in VPI group than in VPC group(P<0.05).We compared the results of different operative age by VPI after surgery.The results showed that postoperative RVPI was in direct proportion to operated age.VPI in the group less than 3 years of age.VPI in the group less than 3 years of age was 28.57%,but in the group of over 7 years of age was 96.43%.Both showed significant difference(P<0.01).

[Reconstruction of large performated maxillofacial defect with immediated revascularized flap]

Patients with large perforated maxillofacial defects resulting from combined craniomaxillofacial resection or extended extra cranio-maxillofacial resection due to malignances in this region had been reconstructed with large revascularized myocutaneous flap or combined pedicled myocutaneous flap with revascularized flap.Since January,1981,a total of 29 flaps was used,of which 28 flaps survived successfuly,whereas one free forearm flap being failed to survive due to venous embolization was replaced with pedicled forehead flap.The results in postoperative appearance and rehabilitation of physiological function were relatively satisfactory.Finally,selection of flap and method of reconstruction were introduced and experiences on immediate reconstruction after malignance resection reported.

[Quantitatively study of voice onset time-Glottal stop]

To quantitatively evaluate the acoustic characteristics of glottal stop, pronunciation of/ka/in 10 normal subjects and 14 patients with cleft palates were analyzed by sound spectrography and 20 msec in all normal articulation of /ka/ with an average time of 44.6 msec.In the test group of /ka/ demonstrated an average time of 20.8 msec.The inverse correlation ship between VOT and the psyco-acoustical judgment for the degree of distortion was demonstrated to be significant.

[A comparative study of velopharyngeal function after palatoplasty with different age group]

That the most suitable age of palatoplasty is still an argumentative question.The final purpose of palatoplasty is to obtain the satisfactory effectiveness is to obtain the satisfactory effectiveness of phonetic distinctness.So,early palatoplasty is suported by more more experts and patient's parents.This study detected 60 cases velopharyngeal function after traditional palatoplasty with two flaps,adopting nasopharyngeal fiberscope and detective system of image processing and quantitative analysis of velopharyngeal function,for long term evaluation of traditional palatoplasty with different operative success iin early palatoplasty group (less than 3 years old) was 80.0% while that in later palatoplasty group (more than 6 years old) was 53.3%.From other aspects of types of velopharyngeal competence,mobility of soft palate and rate of velopharyngeal coronary contraction,the author described advantages of early palatoplasty.