ABSTRACT
Objective:To investigate the clinical characteristics of dermatomyositis (DM) patients with positive anti-melanoma differentiation-associated protein 5 (MDA5) antibody-complicated with pneumomediastinum.Methods:Clinical data of patients with anti-MDA5 antibody-positive DM with or without pneumomediastinum from March 2017 to December 2019 in Ningbo First Hospital were collected and analyzed. The international literature were reviewed and compared. T-test or Mann-Whitney U test was used for measurement data, chi-square test or Fisher exact probability was used for count data. Logistic regression analysis was used to analyze the risk factors for anti-MDA5 antibody-positive DM with pneumomediastinum. Results:Twelve DM patients with -positive anti-MDA5 antibody without pneumomediastinum, and 1 DM patient with positive anti-MDA5 antibody-complicated with pneumomediastinum. Pooling with literature review, 16 DM patients with positive anti-MDA5 antibody-complicated with pneumomediastinum were compared. It was found that the serum ferritin (SF) level [991.6(548.5, 2875.1) ng/ml vs 355 (143.5, 395) ng/ml, Z=-2.506, P=0.012] and the rate of rapid progressive pulmonary interstitial disease (RPILD) in the pneumo-mediastinum group [76.5% vs 16.7%, χ2=10.076, P=0.002] were significantly higher than those in the non-pneumome-diastinum group. Further Logi-stic regression analysis did not show male gender [ OR=0.192, 95% CI(0.009, 4.125), P=0.291]; SF [ OR=1.002, 95% CI(0.998, 1.006), P=0.279]; RPILD[ OR=0.084, 95% CI(0.003, 2.178), P=0.136]; CADM[ OR=0.258, 95% CI(0.009, 7.419), P=0.429] was risk factor for pneumomediastinum. Conclusion:DM patients with positive anti-MDA5 antibody and high seral SF level and rapid progression of pulmonary interstitial disease are more likely to complicate with pneumomediastinum.
ABSTRACT
Objective To study the effects of biofeedback combined with the fixed functional appliance in the modification of mandible in patients with Angle Class Ⅱ malocclusion and retruded mandible.Methods A Iotal of 30 orthodontic patients were divided into two groups,all patients with retruded mandible and normal maxilla,ANB>6°,aged from 9 years and three months to 14 years and 11 months.All patients were treated with Forsus fixed functional appliance combined with MBT straight-wire appliance.Muscular activity of the superficial masseter muscle before,during,and after treatment.was evaluated by assessing the average integrated eleetromyogram (EMG) .The biofeedback was performed during functional treatment in the study group,the muscular activity of the superficial masseter muscle was turned into the signal which can be read and seen by patients,and the patient can control the muscular activity of the superficial masseter muscle in a certain extent under the help of instrument.After 6 weeks fixed functional appliance treatment,the biofeedback treatment was performed in the study group with the help of instrument and trained for 10 times,and the patients could trained by themselves for 20 minutes everyday.Results The biofeedback treatment was able to regulate the muscular activity of the masseter muscle and prevent the return of muscle function and the tendency to seat the condyle back toward the fossa,maintain the treatment effect;after biofeedback treatment the decreased postural EMG activity in the masseter muscle was steady,but without statistical significance (P>0.05).Conclusion The biofeedback treatment can maintain the muscular activity of the masseter muscle effectively,enhance the effect of functional treatment and keep the stability of the mandibular position.