Effect of Yiqi Jiedu Prescription-containing Serum on Proliferation of mTEC and Regulatory T Cells in Myasthenia Gravis Patients with Thymus Hyperplasia / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Yiqi Jiedu prescription-containing serum on the proliferation of medullary thymic epithelial cells （mTEC） and regulatory T （Treg） cells in myasthenia gravis （MG） patients with thymus hyperplasia. MethodAccording to serological methods，35 SD rats were adaptively fed for one week and randomized into the low-，medium-， and high-dose Yiqi Jiedu prescription groups，control group， and prednisone group，with seven rats in each group， which were then gavaged with the corresponding drugs for one week for preparing the drug-containing serum. The effect of Yiqi Jiedu prescription-containing serum at different concentrations on the proliferation of mTEC and Treg cells were determined by cell counting kit-8 （CCK-8） assay. Besides， the effect of mTEC and Yiqi Jiedu prescription-containing serum on Treg cell proliferation were observed through co-culture. ResultThymocytes were cultured for a period of time. Their mean positive rate revealed by flow cytometry using mTEC characteristic marker Ulex europaeus agglutinin Ⅰ （UEAI） was 92.54%. Treg cells were sorted by magnetic beads. The purity of Treg cells after repeated magnetic bead sorting was as high as 92%. mTEC and Treg cells showed high positive expression rates，and their cell purity met the requirements of subsequent experiments. When the concentration of Yiqi Jiedu prescription-containing serum was 2.5%-15%，it exhibited an inhibitory effect against mTEC and Treg cells. When the concentration was equal to or greater than 20%，it promoted cell proliferation，which was further enhanced with the extension of action time. The results after 48 h of culture showed that compared with the control group，prednisone and low-dose Yiqi Jiedu prescription had no significant effect on the proliferation of these two kinds of cells，but the medium- and high-dose Yiqi Jiedu prescription remarkably reduced their proliferation inhibition rate （P<0.01）. After co-culture with mTEC， the control group was not significantly different from the prednisone group and the low-dose Yiqi Jiedu prescription-containing serum group in the proliferation of Treg cells，while the medium- and high-dose Yiqi Jiedu prescription-containing serum groups significantly lowered the proliferation inhibition rate （P<0.01）. ConclusionYiqi Jiedu prescription-containing serum affects the proliferation of mTEC and Treg cells in MG patients with thymus hyperplasia. Compared with the solely cultured Treg cells isolated from MG patients，the Treg cells co-cultured with mTEC exhibit enhanced proliferation in MG patients，suggesting that mTEC can regulate the proliferation of Treg cells. This effect becomes more obvious after the intervention with Yiqi Jiedu prescription-containing serum，indicating that intervention effect of Yiqi Jiedu prescription on Treg cells can be produced during its treatment of mTEC， which may be one of the mechanisms of Yiqi Jiedu prescription-containing serum in alleviating MG.

Perioperative management and complication control of Le Fort Ⅲ osteotomy in children with syndromic craniosynostosis / 中华口腔医学杂志

Objective: To summarize the preliminary efficacy, perioperative management and complications of Le Fort Ⅲ osteotomy and midface distraction in patients with syndromic craniosynostosis by retrospective analysis, and to provide clinical experience for reference. Methods: From October 2017 to January 2020, 20 patients with syndromic craniosynostosis underwent Le Fort Ⅲ osteotomy and distraction in The Department of Oral and Maxillofacial Surgery of Peking University International Hospital, including 11 males and 9 females, were involved. The median age was 7 years (1.5 to 15 years). Preoperative risk prevention plan was put forward by multidisciplinary evaluation, and preoperative intervention was carried out. The diagnostic data of SNA, airway volume, polysomnography (PSG), ophthalmology and occlusal relationship were obtained through specialized examination, and osteotomy and distraction surgical plan was formulated through virtual surgical planning. CT was taken 1 week and 3, 6, 12 months after operation, PSG and eye protrudence examination were conducted to evaluate the therapeutic effect, syndrome type, multiple disciplinary treatment (MDT) intervention, occurrence and outcome of complications were summarized. Results: There were 15 cases of Crouzon syndrome and 5 cases of Pfeiffer syndrome. Sleep apnea was the first complaint in 18 cases and exophthalmia in 2 cases. Preoperative interventional therapy included 4 cases of adenoid surgery, 2 cases of continuous positive airway pressure and 2 cases of maxillary expansion. The most common surgical complications were accidental fracture (14/20 cases, 70%), cerebrospinal fluid fistula (2 cases), internal carotid cavernous sinus fistula (1 case), postoperative hyponatraemia (5 cases), crying syndrome (2 cases), wound infection (2 cases), trichiasis of lower eyelid (4 cases), and nasal malformation (1 case). Three cases underwent unplanned secondary surgery. SNA, airway volume and mean percutaneous arterial oxygen saturation (SpO2) six months after operation were significantly higher than those before operation (F=10.09, P=0.001; F=5.13, P<0.001; F=10.78, P=0.001), and the protrusion and apnea hypopnea index were significantly lower than those before surgery (F=6.73, P=0.010; F=18.47, P<0.001). There were no significant differences in SNA, airway volume, mean SpO2, ophthalmology between 6 months after surgery and 1 year after surgery (P>0.05). Conclusions: Perioperative safety assessment and early intervention of MDT is an effective diagnosis and treatment model of Le Fort Ⅲ osteotomy and distraction for syndromic craniosynosis. The operative complications are mainly local, and systemic complications are controllable.

Neuropeptide Y Y1 receptor antagonist PD160170 promotes osteogenic differentiation of rat bone marrow mesenchymal stem cells in vitro and femoral defect repair in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of neuropeptide Y (NPY) Y1 receptor antagonist PD160170 in promoting osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and accelerating healing of femoral defect in rats.</p><p><b>METHODS</b>The third generation of rat BMSCs were treated with PBS (control) or 10, 10, or 10 mol/L NPY Y1 receptor antagonist PD160170. After 7 and 14 days of treatment, the cells were examined for osteogenic differentiation with alkaline phosphatase (ALP) and alizarin red staining. At 7 and 21 days of treatment, the mRNA and protein expressions of collagen type I (COLI), osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) in the cells were detected using q-PCR and Westem Blotting. In a male SD rat model (body weight 300∓20 g) of bilateral femoral condyle defects (2.5 mm in diameter), the effect of daily local injection of 0.2 mL PD160170 (10 and 10 mol/L, for 28 consecutive days) in promoting bone defect repair was evaluated with micro-CT scans.</p><p><b>RESULTS</b>ALP and alizarin red staining showed that the BMSCs treated with PD160170, at the optimal concentration of 10 mol/L, contained more intracellular cytoplasmic brown particles and mineralized nodules in extracellular matrix than PBS-treated cells. PD160170 (10 mol/L) significantly up-regulated the mRNA and protein expressions of COLI at day 7 and those of OCN and Runx2 at day 21 (P<0.05). In the rat models of femoral bone defect, the volume/tissue volume ratio, bone mineral density and the number of bone trabeculae were significantly greater in 10 mol/L PD160170 group than in the control group (P<0.05), but the bone trabecular thickness (P=0.07) and bone volume (P=0.35) were similar between the two groups.</p><p><b>CONCLUSION</b>NPY Y1 receptor antagonist PD160170 can promote osteogenic differentiation of BMSCs and healing of femoral defects in rats, suggesting the potential of therapeutic strategies targeting NPY Y1 receptor signaling in the prevention and treatment of bone fracture and osteoporosis.</p>

Protective effects of perfluorocarbon combined with ligustrazine against lung ischemia-reperfusion injury in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effects of perfluorocarbon and ligustrazine in protecting the lungs against ischemia-reperfusion injury in rats.</p><p><b>METHDS</b>Forty SD rats with ischemia-reperfusion lung injury were randomized equally into control, ligustrazine, perfluorocarbon, and perfluorocarbon plus ligustrazine groups and received the corresponding treatment via the tail vein 5 min before reperfusion. The lung tissues were harvested and the levels of malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD) and tumor necrosis factor-α (TNF-α) were detected 3 h after reperfusion. The pathological changes and pathological scores of the lung tissues were analyzed.</p><p><b>RESULTS</b>MDA and MPO levels were significantly lower and SOD activities significantly higher in the lung tissues in the 3 treatment groups than in the control group (P<0.05). The rats in the combined treatment group showed a significantly lower MPO level and a significantly higher SOD activity than those treated with ligustrazine or perfluorocarbon alone (P<0.05). No significant difference was found in TNF-α levels in the lung tissues among the 4 groups (P>0.05). The lung tissues in the control group showed obvious edema and exudation, and the tissues in ligustrazine and perfluorocarbon groups showed no edema but with a few red blood cells and exudation; no edema was found in the combined treatment group with only a small amount of exudation. The pathological scores differed significantly among the 4 groups.</p><p><b>CONCLUSION</b>Perfluorocarbon and ligustrazine, especially in combined use, can promote endogenous oxygen free radical scavenging, decrease peripheral blood proinflammatory cytokines, and inhibit neutrophils filtration in the lungs of rats with ischemia/reperfusion lung injury.</p>

Study on the distribution of Chinese medical constitutions of hypertension complicated diabetes patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the distribution features of Chinese medical constitutions in hypertension complicated diabetes patients.</p><p><b>METHODS</b>Recruited were 251 primary hypertension inpatients at the Department of Neurology and the Department of Cardiology, Mindong Hospital of Ningde City from October 2010 to March 2011. They were assigned to two groups according to whether they were complicated with diabetes, i.e., the primary hypertension complicated diabetes (as the case group, 78 cases) and the primary hypertension without complicated diabetes (as the control group, 173 cases). The constitution types were investigated by questionnaire. The constitution type distribution was compared between the two groups. The data including gender, age, and the distribution of the constitution type were compared between the two groups. The levels of TG, TC, LDL-C, Hb, FPG, and ALB were detected on the 2nd day after admission. The levels of TG, TC, LDL-C, Hb, and ALB were compared be- tween the two groups in patients of yin deficiency constitution, phlegm dampness constitution, and qi deficiency constitution.</p><p><b>RESULTS</b>There was no statistical difference in the hypertension grading, the disease course, and chronic disease complications between the two groups (P > 0.05). The main constitution types were yin deficiency (accounting for 26.0%), phlegm dampness (accounting for 19.1%), and qi deficiency (accounting for 19.1%) in the control group. The main constitution types were yin deficiency (accounting for 32.1%), phlegm dampness (accounting for 30.8%), and qi deficiency (accounting for 17.9%) in the case group. The ratio of phlegm dampness type in the case group was higher than that in the control group with statistical difference (P = 0.041). There was no statistical difference in the constitution distribution in the same gender between the two groups (P > 0.05). There was no statistical difference in the constitution distribution in those younger than 80 years between the two groups (P > 0.05). Compared with those older than 80 years in the control group, the ratio of phlegm dampness was higher, and the ratios of yang deficiency, yin deficiency, qi deficiency, and dampness heat were lower in the case group with statistical difference (P = 0.020). There was no statistical difference in the constitution distribution among different age stages in the case group (P > 0. 05). But there was statistical difference in the constitution distribution among different age stages in the control group (P < 0.05). The yin deficiency and qi deficiency constitutions were dominated in thinner patients of the control group, while yin deficiency constitution was dominated in thinner patients of the case group, showing no statistical difference between the two groups (P > 0.05). There was no statistical difference in the distribution of constitution type in overweight patients between the two groups (P = 0.458). Compared with those of gentle type constitution in the same group, the levels of TC and LDL-C increased in those of phlegm dampness constitution in the two groups (P < 0.05). The level of TC increased in those of qi deficiency constitution in the case group. The level of Hb decreased in those of qi deficiency constitution in the control group (P < 0.05). Compared with those of qi deficiency constitution in the same group, the levels of TC and Hb obviously increased in those of phlegm dampness constitution in the control group (P < 0.05). The level of ALB increased in those of yin deficiency constitution in the case group (P < 0. 05). Compared with the control group, the level of FPG of those of each constitution increased in the case group (P < 0.05) ,.and the level of TC increased in those of qi deficiency constitution (P = 0.007).</p><p><b>CONCLUSIONS</b>The main constitution types of hypertension complicated diabetes patients were yin deficiency, phlegm dampness, and qi deficiency. The ratio of phlegm dampness was higher in hypertension complicated diabetes patients than hypertension without complicated diabetes patients. The levels of TC and LDL-C were higher in those of phlegm dampness constitution type. The level of TC was higher in hypertension complicated diabetes patients of qi deficiency constitution.</p>

Application of tunable guide device in prominent mandibular angle osteotomy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the application and therapeutic effect of tunable guide device in correction of prominent mandibular angle.</p><p><b>METHODS</b>Since 2007, 50 cases with prominent mandible angle underwent mandible angle osteotomy with the tunable guide device. The patients were followed up for 3-6 months.</p><p><b>RESULTS</b>No severe complication happened. Local seroma occurred in one case. Improved esthetic results were achieved at both frontal and oblique view.</p><p><b>CONCLUSIONS</b>The mandibular angle osteotomy with the tunable guide device makes the procedure safe and easily performed.</p>

The establishment of a rapid fluorescent focus inhibition test for testing rabies virus neutralizing antibody / 中华流行病学杂志

Objective To establish a rapid fluorescent inhibition test (RFFIT) for testing rabies virus neutralizing antibody and the titer of rabies virus neutralizing antibody.CVS-11 was used as the standard challenge virus,and three generations prepared for the establishment of the virus library.Methods International standard for rabies immunoglobulin was used as the reference serum.RFFIT test was established under consulting the protocol of Institute of Pasteur,and its specificity,stability and reproducibility were validated.Results We established the RFFIT which showed both good specificity ( 100% ) and reproducibility (P＞0.5).Conclusion The establishment of RFFIT test perfected the rabies laboratory techniques and would enhance the overall ability in detecting rabies in China.

Effects of high-frequency electromagnetic field on morphology of hippocampal cells in female rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze the effects of high-frequency electromagnetic field (HF-EMF, 30 MHz, 0-1600 V/m) on the apoptosis and ultramicrostructure of the hippocamp and demonstrate the cytotoxicity of hippocamp.</p><p><b>METHODS</b>120 Wistar female adult rats were randomly divided into ten groups based on body weight with different levels of 30 MHz electromagnetic field (0, 25, 100, 400, 1600 V/m) for eight hours daily. Five group rats were irradiated for three days. The other five group rats were irradiated for fifty-six days. Weekly the rats were continuously exposed five days. The apoptotic rate of the hippocamp was detected with TUNEL System. Meanwhile, the ultramicrostructure was observed with the transmission electron microscope.</p><p><b>RESULTS</b>(1) There was no significant difference on the apoptotic rate and pathological change of the hippocamp cell between the exposure and the control groups through short term experiment (P > 0.05). (2) The apoptotic rate of the granulocyte on the DG campus of the hippocamp in the 400 V/m group and the 1600 V/m group (0.165% +/- 0.049%, 0.189% +/- 0.049% respectively) were increased significantly (P < 0.01) through inferior chronic experiment compared with the control group (0.052% +/- 0.016%). Along with the increase of radiation dose, the ultramicrostructure of the neuron cell appeared more abnormal cells. Especially there were marked change on the neuron in the 1600 V/m group.</p><p><b>CONCLUSIONS</b>There is no association between cell apoptotic rate of the hippocamp and short period exposure to HF-EMF (30 MHz, 25-1600 V/m). However inferior chronic exposures to HF-EMF might induce the cytotoxicity, especially in the high dose exposure (1600 V/m) under our experiment.</p>

Evaluation on the safety and efficacy of lyophilized purified human rabies vaccine (CTN-Vero-RV) / 中华流行病学杂志

<p><b>OBJECTIVE</b>To observe the safety and efficacy of lyophilized purified human rabies vaccine CTN-Vero RV, CTN strain produced in Vero cells.</p><p><b>METHODS</b>450 healthy volunteers were divided into two groups, with 300 of them receiving CTN-Vero-RV (rabies vaccine for human use made in Vero cells with CTN strain) while 150 of them receiving PVRV to serve as control group. All the subjects were immunized on days 0, 3, 7, 14 and 28 at deltoid muscle respectively. Local and systemic reactions were observed and sera were collected for neutralizing antibody testing using RFFIT. 365 and 730 days after the first dose, sera from the 212 and 176 subjects of the studied group while 97 and 80 subjects from the control group were collected to test for neutralizing antibody.</p><p><b>RESULTS</b>No severe local or systemic reactions were observed after immunization was performed in the two groups. On days 3, 7, 14, 28 and 365 after the first dose, the antibody positive rates appeared to be 2.35%, 80.78%, 100.00%, 100.00%, 98.58% and 73.30% in the study group and 4.00%, 87.20%, 100.00%, 100.00%, 97.94% and 76.25% in the controls respectively. On day 0, 3, 7, 14, 28, 365 and 730, GMT of the neutralizing antibody level were 0.12, 1.01, 9.83, 12.61, 3.68 and 2.81 IU/ml in the study group while 0.13, 1.18, 10.24, 11.61, 4.18 and 1.92 IU/ml were seen in the control group respectively. There were no significant differences in both antibody positive rates and GMT between the two groups on days 3, 7, 14, 28, 365 or 730 (P > 0.05).</p><p><b>CONCLUSION</b>CTN-Vero-RV was safe and effective as well as could generate a persistent immune response.</p>

Transcranial surgical correction of cranio-orbital fibrous dysplasia with lateral orbital approach / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the transcranial surgical method with lateral orbital approach for the treatment of cranio-orbital fibrous dysplasia.</p><p><b>METHODS</b>Lateral orbital transcranial extradural approach was adopted to correct complicated fibrous dysplasia in which the frontal, orbital, sphenoid, temporal bones were involved. Partial lesion removal and optic nerve decompression were performed through the transcranial extradural route by fronto-temporal cranial bone flap exposure. The fronto-orbital skeleton was shaped after bone flap deactivation.</p><p><b>RESULTS</b>8 cases were treated successfully with no complication. The period of follow-up ranged from 9 months to 3 years. The appearance and the vision improved greatly. Cranial CT showed good bony union with no relapse.</p><p><b>CONCLUSIONS</b>Lateral orbital transcranial surgical approach is an optimal technique to correct cranio-orbital fibrous dysplasia.</p>

Female genital toxicities of high-frequency electromagnetic field on rats / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study on the effects of sub-chronic exposures to high-frequency electromagnetic field (HF-EMF) on the estrous cycle, ovarian pathological changes and related hormones and preliminarily investigate the female genital toxicities of HF-EMF in rats.</p><p><b>METHODS</b>60 Wistar female adult rats were randomly divided into five groups based on body weight and radiated with different levels of 30 MHz electromagnetic field (0, 25, 100, 400 and 1600 V/m) for eight hours daily. Weekly the rats were continuously exposed five days. From the 48th day the four stage of estrus cycle were observed with smear method of the vaginal cell. Fifty-six days later the serum levels of sexual hormones were detected with the radioimmunoassay on estrus stage. The constituent ratio of the distinct follicle number on ovaries were observed with the HE staining and the ultrastructure was observed with the transmission electron microscope. Meanwhile, the ovarian humid weight and organ coefficient were observed.</p><p><b>RESULTS</b>There was no significant difference in ovarian humid weight and organ coefficient between the exposure and the control groups. The time of proestrus in the 100 V/m group, the 400 V/m group and the 1600 V/m group was decreased significantly [(15.00 +/- 5.06), (11.40 +/- 2.05) and (10.56 +/- 0.96) h in the exposure group compared with (18.70 +/- 2.96) h in the control group, P < 0.01], and the time of Anestrum in the 400 V/m group and the 1600 V/m group were increased significantly [(101.20 +/- 17.81) and (115.33 +/- 19.28) h in the exposure group compared with (69.80 +/- 11.42) h in the control group, P < 0.01)]. Serum LH in the 400 V/m and 1600 V/m group was increased significantly [(11.02 +/- 1.11) and (14.70 +/- 1.94) mU/ml in the exposure groups compared with (8.70 +/- 0.53) mU/ml in the control group, P < 0.01], and serum E2 was decreased significantly [(57.16 +/- 31.56) and (50.57 +/- 25.16) pg/ml in the exposure groups compared with (95.04 +/- 32.62) pg/ml in the control group, P < 0.01]. The composition ratio of the corpus luteum/albicans number in the 400 V/m group and the 1600 V/m group was increased significantly (19.75% and 19.04% in the exposure groups compared with 14.01% in the control group, P < 0.05). The composition ratio of the atretic follicle number was increased significantly in the 100 V/m, the 400 V/m and the 1600 V/m group (8.45%, 9.95% and 11.70% in the exposure groups compared with 7.72% in the control group, P < 0.01). The composition ratio of the mature follicle and the pri/sec follicle was decreased significantly in the 400 V/m and the 1600 V/m group (1.50% and 1.55% in the exposure groups compared with 3.36% in the control group. 22.24% and 21.09% in the exposure groups compared with 26.60% in the control group, P < 0.01). Along with the increase of radiation dose, the ultrastructure of cell on the ovaries appeared more abnormal.</p><p><b>CONCLUSIONS</b>The toxicities of female gonads are closely associated with exposures to HF-EMF. The nonage damage of female gonadal toxicities might emerge on the ovaries.</p>

Expression of homeobox gene MSX-2 during cranial suture fusion of SD rats / 上海第二医科大学学报

Objective To investigate the expression of homeobox gene MSX-2 during cranial suture fusion of SD rats and discuss its significance. Methods SD rats aged 1, 2, 5, 8, 12, 15, 18, 22, 30 and 45 days were selected, and immunohistochemistry and Real-time PCR were employed to localize and quantify the expression of MSX-2 in different regions of cranial sutures. Results MSX-2 expressed in calvarial suture tissues including the extreme ends of the osteogenic fronts and the underlying dura mater. The expression of MSX-2 was low in posterior frontal suture (PF) and sagittal suture (SAG) from postnatal day 1 to day 8 before the initiation of suture fusion, while it was higher in PF than in SAG from postnatal day 12 to day 22 after the initiation of PF suture fusion. The expression of MSX-2 significantly declined in PF and was moderately higher than that in SAG from postnatal day 30 to day 45 after the initiation of suture fusion. Conclusion There is different expression of MSX-2 in PF and SAG during different suture fusion periods, which suggests the expression of MSX-2 may participate in the regulation of cranial bone development and the fusion of cranial sutures.

Construction and functional identification of eukaryotic expression vector carrying Sprague-Dawley rat MSX-2 gene / 中华整形外科杂志

<p><b>OBJECTIVE</b>To construct a high effective eukaryotic expressing plasmid PcDNA 3.1-MSX-2 encoding Sprague-Dawley rat MSX-2 gene for the further study of MSX-2 gene function.</p><p><b>METHODS</b>The full length SD rat MSX-2 gene was amplified by PCR, and the full length DNA was inserted in the PMD1 8-T vector. It was isolated by restriction enzyme digest with BamHI and Xhol, then ligated into the cloning site of the PcDNA3.1 expression plasmid. The positive recombinant was identified by PCR analysis, restriction endonudease analysis and sequence analysis. Expression of RNA and protein was detected by RT-PCR and Western blot analysis in PcDNA3.1-MSX-2 transfected HEK293 cells.</p><p><b>RESULTS</b>Sequence analysis and restriction endonudease analysis of PcDNA3.1-MSX-2 demonstrated that the position and size of MSX-2 cDNA insertion were consistent with the design. RT-PCR and Western blot analysis showed specific expression of mRNA and protein of MSX-2 in the transfected HEK293 cells.</p><p><b>CONCLUSIONS</b>The high effective eukaryotic expression plasmid PcDNA3.1-MSX-2 encoding Sprague-Dawley Rat MSX-2 gene which is related to craniofacial development can be successfully reconstructed. It may serve as the basis for the further study of MSX-2 gene function.</p>

Establishment of diagnostic criteria for cranio-orbito-zygomatic hypoplasia with computer-assisted measurement / 中华整形外科杂志

<p><b>OBJECTIVE</b>To establish the quantitative diagnostic criteria for cranio-orbito-zygomatic deformity (COZD).</p><p><b>METHODS</b>Computer-assisted three-dimensional (3-D) CT measurement was performed in 30 cases with unilateral COZD. The differences of the measurement data between the affected and unaffected sides were analyzed. Then the patients were diagnosed and classified according to the affected bone, soft tissue and conjunctival sac. Based on the quantitative diagnosis, 8 patients underwent surgery to test the clinical practicability of the diagnostic criteria.</p><p><b>RESULTS</b>The quantitative diagnostic criteria for COZD could reflect the affected area and the corresponding severity of deformity. It helped to preoperative design and to predict movement of osteotomy segment and. the soft tissue volume needed for augmentation. Good postoperative results were achieved.</p><p><b>CONCLUSIONS</b>The quantitative diagnostic criteria for COZD can describe the affect area and severity of deformity in detail. It is very practical in the guidance of clinical treatment.</p>

Experience of midfacial distraction osteogenesis in upper airway stenosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effects of upper airway stenosis after Le Fort III osteotomy and midfacial distraction osteogenesis (DO).</p><p><b>METHODS</b>Eleven cases (age, 5-16 yrs) with severe midface dysostosis complicated with exophthalmos, anterior crossbite and upper airway stenosis were treated by using Le Fort III osteotomy and midfacial DO from August 2000 to February 2007. The 3D reconstruction of the upper-airway from CT data was used to evaluate the upper airway volume before and after the operation. And meanwhile polysomnography was carried out to demonstrate the upper airway functional changes.</p><p><b>RESULTS</b>There was a 64.3% mean increase [mean, (9.13 +/- 6.94) ml, P < 0.05] in upper airway volume in the 11 cases after the operations. It showed that there was significant improvements in the indexes of polysomnography after the operations, such as apnea and hypopnea index, average SaO2, minimum oxygen saturation and snore index.</p><p><b>CONCLUSIONS</b>The Le Fort III osteotomy and midfacial distraction osteogenesis can efficiently relieve the symptoms of upper-airway stenosis in severe midfacial dysostosis.</p>

Changes of different section area at different parts of upper-airway after Le Fort III osteotomy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effects of Le Fort III osteotomy and midface distraction osteogenesis (DO) on the upper-airway narrow.</p><p><b>METHODS</b>Since 2000, 11 cases (10 cases of Crouzon syndrome and 1 case of Apert syndrome) with severe midface deficiency were treated with Le Fort III osteotomy and midface DO. The section area of different parts of upper-airway were tested by computer assistants image measurement preoperatively and postoperatively. Some patients received sleep function monitoring.</p><p><b>RESULTS</b>The face appearance and the function of upper-airway improved significantly after Le Fort III osteotomy and Midface DO. The section area at the level of posterior nasal spine and uvula increased obviously after treatment (P < 0.05), however the section area at the level of epiglottis and separation between airway and esophagus were not obviously enlarged (P > 0.05).</p><p><b>CONCLUSIONS</b>Midface DO after Le Fort III osteotomy can effectively improve the upper-airway narrow, especially the upper part from uvula.</p>

Research and clinical application of computer-aided design of craniofacial prosthesis using mirror technique / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility of creating a 3D-CAD model of craniofacial prostheses through mirror technique to repair the unilateral craniofacial defects and restore craniofacial symmetry.</p><p><b>METHODS</b>Patients with unilateral craniofacial defects underwent spiral CT scanning. CAD3-D image was reconstructed ad 3-D CAD model of craniofacial prosthesis was created with mirror technique, Boolean operation and rapid prototyping technique. Then the prosthesis made of bioactive artificial bone was made through plaster cavity block.</p><p><b>RESULTS</b>15 cases were treated with no complications. Good symmetry was achieved after operation.</p><p><b>CONCLUSIONS</b>Designing the craniofacial prosthesis with mirror technique guarantees excellent functional and cosmetic results for repairing the unilateral craniofacial defects.</p>

Reconstruction of the acquired orbital deformities / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the reconstruction of acquired orbital deformities.</p><p><b>METHODS</b>Through coronal incisions, subciliary incisions and buccal sulcus incisions, or periorbital wound, the displaced orbital walls were repositioned after osteotomy. And the mandibular outer cortex was used to repair the bone defect, so as to restore the orital integrity.</p><p><b>RESULTS</b>From Sept. 2002 to Jun. 2006, 64 patients with acquired orbital deformities were treated. The integrity of orbit and eyeball location recovered very well.</p><p><b>CONCLUSIONS</b>Restoration of the orbital integrity is the key to the treatment of acquired orbital deformities. The periorbital deformities should be corrected after osteotomy with mandibular outer cortex for bone defect.</p>

3-dimensional position changes of periorbital structures after midface distraction osteogenesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the 3-D position changes of periorbital structures after midface distraction osteogenesis in patients with Crouzon syndrome.</p><p><b>METHODS</b>The CT data of 8 cases who had accepted the midface distraction osteogenesis following Le Fort III osteotomy were retrospectively analyzed. The patients were averagely 11.9 years old, and the CT was performed before and one year after operation. After 3-D image reconstruction, a right-hand coordinate system based on the preoperational Frankfurt Plane was then established. The pre- and post-operative positions of the superior orbit point (SOr), inferior orbit point (IOr), median orbit point (MOr), lateral orbit point (LOr), anterior ocularis point (AO), ocularis eyeball point (PO) and the four insertion ocularis rectus were documented and compared. The positions of these marked points in normal controls were also documented and compared with those in patients.</p><p><b>RESULTS</b>After midface distraction osteogenesis, the position of AO was not changed significantly on the y-axis and z-axis, but the distance between two AO points on x-axis was reduced by 3.40 mm; IOr moved averagely 12.24 mm on y-axis and 4.25 mm on z-axis, MOr moved averagely 10.11 mm on y-axis and 2.80 mm on z-axis, LOr moved averagely 9.86 mm on y-axis and 2.31 mm on z-axis. The Inferior Rectus attachment moved averagely 3.63 mm on y-axis and 2.98 mm on z-axis. No other significant change was observed on other marked points.</p><p><b>CONCLUSIONS</b>Midface distraction osteogenesis following Le Fort III osteotomy can significantly move the medial, lateral and inferior peri-orbital bone structure anteriorly and inferiorly. The eyeballs have no markedly sagittal position changes after distraction except slight medial, downwards movements and anterior-upwards rotations.</p>

Surgical correction of craniofacial dysostosis with midface distraction osteotogenesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>Correction of craniofacial dysostosis with midface distraction osteotogenesis.</p><p><b>METHODS</b>Le Fort III osteotomy has been employed through coronal route on patients with midface craniofacial dysostosis such as Crouzon and Apert syndrome. Then a REDII distraction device was set up, and the device bars directed. The distraction begins 6.4 days after the surgery, with a rate of 1 mm per day. When midface approaching the right position, i.e. an slightly over correction of occlusion is reached, the distraction stops and the device is held for the next 2-4 months.</p><p><b>RESULTS</b>There are 8 cases completed all the therapy with an average age of 11.9 years old. The midface had been moved averagely 9.7 mm forwards and 1.6 mm downwards. The features had been improved obviously and the occlusions reach nearly normal. The exophthalmos reduced from 20.3 mm to 11.9 mm. In cephalometry, SNA was averagely enlarged 9 degrees, and ANB enlarged 8.8 degrees. The snore during sleeping was also improved in 87.5% cases. No serious complication had occurred except minor one such as 1 case of seroma and 1 case of infection around pin on scalp. According to 5 months averagely follow-up, there is no recurrence in our list.</p><p><b>CONCLUSIONS</b>Midface distraction osteotogenesis is propitious to teenage or severe cases of craniofacial dysostosis.</p>