Sagittal fracture of mandibular condyle: a review of 151 cases / 中华口腔医学杂志

Objective@#A retrospective research was made to summarize the clinical characteristics, treatment methods, results of the adult cases with sagittal fracture of mandibular condyle (SFMC).@*Methods@#One hundred and fifty-one cases of hospitalized patients were enrolled. The age, sex, etiology, level of fracture, degree of displacement, associated facial fractures, treatment methods and results were retrospectively analyzed.@*Results@#The patient′s age ranged from 16 to 81 years old, with a median age of 38.5 years. The male to female ratio was 2.97∶1. The most involved age group was 20-29 years old [35.1% (53/151)]. Falls [53.6% (81/151)] were the most common cause. According to the classification of He (2009) and Duan (2011), the most common type of SFMC was type A [60.5% (130/215)] and the displacement type [80.9% (174/215)]. Eighty-six point zero percent (185/215) of SFMC were treated by surgery. The surgical rates of type A, B and M fractures were 91.5% (119/130), 79.6% (43/54) and 88.5% (23/26), with significant differences between the groups (P<0.05). The surgical rates of the displacement and dislocation type were 89.7% and 100%, with significant differences. The differences between the fixations of type A, type B and type M fractures were statistically significant. The follow-up results showed that, 78.7% (59/75) of patients treated with surgery had normal occlusion, no joint symptoms and no limited mandibular movement. Patients treated with conservative therapy had good occlusion and an average maximum mouth opening of 36.25 mm with malunion occurred in 5/6 of the condyles.@*Conclusions@#Under appropriate surgical indications, surgical treatment of SFMCs could achieve significantly better outcomes than conservative treatment.

Efficacy of single-session plasmapheresis therapy alone for the treatment of toxic epidermal necrolysis in 17 cases: a clinical observation / 中华皮肤科杂志

Objective To evaluate the clinical efficacy of single-session plasmapheresis therapy alone for the treatment of toxic epidermal necrolysis (TEN),and to investigate its adverse reactions.Methods Patients with TEN receiving single-session plasmapheresis therapy alone were collected from the Second Affiliated Hospital of Xi'an Jiaotong University between September 2010 and December 2017.Clinical data on the disease severity,clinical efficacy,hospitalization duration and adverse reactions were analyzed.Results A total of 17 patients with TEN were enrolled into this study,including 9 males and 8 female,with an average age of 36.1 ± 25.4 years.Their initial SCORTEN and STENS scores were 2.1 ± 1.24 and 29.9 ± 6.6 respectively.After treatment,the STENS score decreased to 3.5 ± 1.8.Of the 17 patients,15 were cured after single-session plasmapheresis therapy,1 showed response to the treatment,and 1 died.The duration of intensive care unit stay was 6.4 ± 1.8 days,and the total hospitalization duration was 12.1 ± 5.7 days.There was no significant difference in the STENS score among the day 1,4,7,10 and 20 after hospital admission (F =18.569,P ＜ 0.05).No severe adverse reactions were observed,except 2 cases of plasma allergy.Conclusion Single-session plasmapheresis therapy alone is effective for the treatment of TEN without obvious adverse reactions.

Comparison of the clinical features and treatment outcomes of oral and maxillofacial space infection between diabetic and non-diabetic patients / 实用口腔医学杂志

Objective:To review and compare the clinical features and treatment outcomes of oral and maxillofacial space infection (OMSI)between diabetic and non-diabetic patients.Methods:Clinical data of 43 diabetic patients with OMSI(simultaneoustly treated by blood sugar control)and 84 of non-diabetic patients with OMSI were reviewed,the clinical features and treatment outcomes were compared.Statistical analyses were conducted by T test,the chi square test and variance analysis.Results:Diabetic patients with OM-SI were older(P =0.000),had more spaces involved concurrently(P =0.035 )and had higher blood sugar at presentation(P =0.000).There was no significant difference between groups about the use and change of antibiotics,the incision times,hospital stay durition and the incidence of the complications.Conclusion:The prognosis of the diabetic patients with OMSI under the strict control of the blood glucose concentration has no significant difference from the non-diabetic patients with OMSI.Diabetic patients with OMSI have older age and more spaces involved,and special attention should be paid.

A retrospective study of 1 009 patients with oral and maxillofacial fresh trauma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the epidemiological characters of fresh maxillofacial fractures in hospitalized patients by the retrospective study.</p><p><b>METHODS</b>From Jan. 2008 to Dec. 2013, a total of 1 009 patients with fresh maxillofacial fractures treated at Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology were investigated. The data were statistically analyzed by SPSS 21.0.</p><p><b>RESULTS</b>The male and female ratio was 2.94:1 and 33.5% of the patients aged from 20 to 30 years. The most common cause of the fresh fracture was road traffic accidents (424 cases, 42.0%), followed by tumblings (250 cases, 24.8%) and violence (128 cases, 12.7%). The number of new fracture was increasing gradually in recent years. The patients were at peak of 20-29 years old. The mandibular fracture was the most frequently seen (536 cases, 53.1%), followed by zygomatic complex fractures (233 cases, 23.1%). The simple maxillary fracture was rare and usually combined with other fractures. Infraorbital nerve injury was the most common one in nerve injuries (144 cases). The most common associated injury was extremity injuries (77 cases), followed by thoracic injury (65 cases) and craniocerebral injury (57 cases). Associated injuries were mostly caused by car accidents (127 sites), followed by fall (32 sites). Logictic regression analysis showed that fall and tumbling were risk factors of mandibular and condylar fracture (OR > 1, P < 0.05), while age was a protective factor (OR > 1, P < 0.05).</p><p><b>CONCLUSIONS</b>Oral and maxillofacial fresh fractures most commonly occurred in young people, and the most common cause of fractures was road traffic accidents. Infraorbital nerve was involved frequently. The most common associated injuries was extremity injuries.</p>

A comparative study of three maxillofacial trauma scoring systems in mandible fracture grading / 实用口腔医学杂志

Objective:To compare 3 maxillofacial trauma scoring systems in mandible fracture grading.Methods:Maxillofacial Injury Severity Score(MISS),Maxillofacial Injury Severity Score(MFISS),Mandible Injury Severity Score(S5)were used in the analysis of mandible fracture severity in 313 cases with mandible fractures.The results were statistically analyzed.Results:S5 score showed higher correlation with operation time,operation charge and hospitalization expenses than MFISS and MISS,and it could distinguish single and multiple mandible fractures effectively.It was also a significant factor affecting the cost of hospitalization.Conclusion:The Mandible Injury Severity Score was more suitable for the scoring of mandible fracture.

Correction of enophthalmos following orbital fracture with computer-assisted navigation system / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficiency of individually fabricated titanium mesh to correct enophthalmos following orbital fracture by using computer-assisted navigation system.</p><p><b>METHODS</b>Forty- nine patients with unilateral orbital fracture were divided into navigation group (25 cases) and non-navigation group (24 cases). All patients underwent orbital reconstruction to correct post-traumatic enophthalmos with individually fabricated titanium mesh. The bilateral global projection and the orbital volumn were measured preoperatively and postoperatively. The depth of titanium mesh was measured postoperatively.</p><p><b>RESULTS</b>Statistical analysis demonstrated the global projection at the affected side increased by (3.35 ± 1.46) mm in navigation group and by (2.25 ± 1.14) mm in non- navigation group postoperatively, and there was a significant difference between the two groups (P < 0.05). The orbital volumn at the affected side decreased by (5.94 ± 2.20) ml in navigation group and by (4.21 ± 2.18) ml in non-navigation group, and there was a significant difference between the two groups (P < 0.05). The depth of titanium was (31.95±2.97) mm in navigation group and (29.27±2.72) mm in non-navigation group, and the values between the two groups differed significantly (P < 0.05).</p><p><b>CONCLUSIONS</b>The use of computer-assisted navigation for the orbital wall reconstruction with individually fabricated titanium mesh can protect the optic nerve reliably and achieve satisfactory results.</p>

Clinical analysis of 24 cases of bisphosphonate-related osteonecrosis of the jaw / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To retrospectively analyze the data of the patients with Bisphosphonate-related osteonecrosis of the jaw over the past five years in our hospital.</p><p><b>METHODS</b>Twenty-four patients with bisphosphonate-related osteonecrosis of the jaw treated in our hospital from 2009 to 2013 were included. The medication, bisphosphonate types, clinical signs and symptom, treatment methods and results were also analyzed.</p><p><b>RESULTS</b>Of the 24 cases, 20 cases suffered from malignant tumors and received intravenous infusion of bisphosphonates and 4 cases took oral bisphosphonates. Three of the 4 cases with osteoporosis had history of glucocorticoid (rheumatoid arthritis). All patients had oral clinical symptoms for an average of 11.6 months, and 19 patients had the history of tooth extraction. There were 11 cases with mandible involved, 10 cases with maxilla involved, and 3 cases with both mandible and maxilla involved. After conservative treatment (3 cases) or operation (21 cases), 10 cases had wound healing, 6 cases were stable with bone exposure, and 4 cases with died bone needed reoperation. During the follow-up period, there was one patient died of primary disease (renal carcinoma).</p><p><b>CONCLUSIONS</b>Both intravenous and oral application routes of bisphosphonates can induce osteonecrosis of the jaw. Bisphosphonate-related osteonecrosis of the jaw can be caused by alveolar trauma. The treatment modality is to relieve the clinical symptoms of bisphosphonate-related osteonecrosis of the jaw.</p>

Use of computer-assisted navigation system in reconstruction of unilateral old zygomatic complex fracture / 中华创伤杂志

Objective To investigate whether the surgery resorting to computer-assisted navigation system (CANS) can enhance effects in managing unilateral old zygomatic complex (ZMC) fracture in comparison with conventional surgery.Methods Twenty-four patients with unilateral old ZMC fracture for which surgical correction was wanted were divided into study group (n =12,treated with navigational surgery) and control group (n =12,treated with traditional surgery) in the 1 ∶ 1 matched case-control study.Therapeutic effects of CANS were evaluated by postoperative CT measurement,subjective satisfaction questionnaire and clinical examination.Results According to postoperative three-dimensional CT measurement,the mean projection and width differentials of bilateral zygomatic bones were 1.58 mm and 1.47 mm in study group,3.58 mm and 3.63 mm in control group,with significant differences between groups.No complications occurred within three months of follow-up.Moreover,the patients in study group were all satisfied with the treatment,but two patients in control group desired further surgery to ameliorate zygomatic shape.Conclusion Surgery with application of CANS improves efficacy of treatment for unilateral old ZMC fracture.

Mutation analysis of ferrochelatase gene in a pedigree with erythropoietic protoporphyria / 中华皮肤科杂志

Objective To characterize the inheritance of erythropoietic protoporphyria (EPP) by detecting the mutations of ferroehelatase (FECH) gene in a Chinese family with EPP. Methods Peripheral blood samples were obtained from 4 patients and 3 unaffected individuals in a family with EPP, as well as from 50 unrelated healthy human controls. PCR was performed to amplify all the 11 exons and flanking sequence of FECH gene followed by direct sequencing. Results A splicing mutation,I.e., IVS3+1G→A, was identified in the proband as well as his symptomatic sister, cousin, grandfather and asymptomatic mother, but not in his asymptomatic father, grandmother, or unrelated healthy controls. The genotypes IVS1-23 T/C and IVS3-48 C/T were noted in the proband, his father, sister, cousin and grandfather, but absent in his mother or grandmother who carried IVS1-23 C/C and IVS3-48 T/T genotypes. Conclusions A novel splicing mutation is found in the FECH gene in a Chinese EPP family, which, together with two lowly expressed alleles IVS1-23T and IVS3-48C, is likely to be responsible for the clinical phenotype of EPP in this family.

Computer-assisted fabricated individual titanium mesh for reconstruction of orbital wall / 北京大学学报(医学版)

Objective: The aim of this study was to develop and assess the computer-assisted fabricated individual titanium mesh technique applied for reconstruction of fractured orbital walls to correct post-traumatic enophthalmus and diplopia. Methods: Twenty patients (12 males and 8 females) were inclu-ded in this study. All of patients suffered from unilateral impure orbital fractures. Group A included 8 patients who were reconstructed for the fractured orbit with computer-assisted fabricated titanium mesh technique. Group B had 12 patients treated with traditional methods (titanium meshes in 2, autogenous bone grafts in 7 and Medpor implantation in 3). CT data of group A was input into a image software to rebuild a 3-D orbit and then mirror the unaffected side onto the affected side to replace the demolished orbit. A resin model of the reshaped orbit was then produced and was used to develop custom-fabricated titanium mesh for repair of the fractured orbital wall. The fabricated mesh was used in operation to reconstruct the orbital wall. Treatment was assessed in comparison with traditional way by means of clinical examinations and CT measurements. Results: The difference between pre-operative and post-operative enophthalmos: the mean value of group A was 2.6 mm, group B was 2.0 mm;the difference between the pre-operative and post-operative enlargement volume of traumatic orbit: the mean value of group A was 4.3 mL, group B was 3.7 mL; Index of Medial orbital wall of both groups was 100% and Index of inferior wall reconstruction of group A was 84.7%, group B was 53.3%; The mean depth of implants of group A was 31.2 mm, of group B was 28.3 mm; Improvement of diplopia of group A was 1.5 quadrants, that of group B was 1 quadrant. There were no infection, gaze restriction, or graft extrusion in all patients after operation. Conclusion: Computer-assisted fabricated titanium mesh technique could provide more accurate orbital reconstruction and improve the correction of enophthalmus and diplopia.

Influence of Natural Antikeratin IgM on Phagocytosis of Staphylococcus aureus by Phogocytes / 中华皮肤科杂志

Objectives To investigate the binding of natural IgM to Staphylococcus aureus and its role in the phagocytosis of S. aureus by phagocytes, and to pave way for further study on the role and mechanism of natural IgM in defense of bacteria. Methods The binding of natural antikeratin IgM 3B4 to S. aureus was analyzed by ELISA and indirect immunoiluorescence. The role of 3B4 in the phagocytosis was analyzed by colony forming assay and flow cytometry (FCM). Results Both ELISA and indirect immunofluorescence proved the binding of natural IgM 3B4 to S. aureus. Colony forming assay found that the amount of colony forming units decreased significantly when 3B4 was added. The analysis of FCM showed that 3B4 augmented phagocytosis of 5. aureus by phagocytes. Conclusions Natural antikeratin IgM 3B4 can bind to S. aureus and regulate the phagocytosis of it, indicating that natural IgM may play some role in the defense against bacterial infection.