ABSTRACT
Objective:Comparison of four methods in intraoperative abduction angles (AA) measurements of human cast immobilization in developmental dysplasia of the hip (DDH) by visual inspection and electronic software according to different body surface markers.Methods:Data were retrospectively collected from January 2019 to November 2021 in a total of 27 patients (54 hips) who underwent closed or simple open reduction. There were 6 males and 21 females with an average age of 13.2 months. Five doctors used visual inspection and mobile phone software to measure the AA of the hip joint immediately during the operation, and compared with the postoperative MRI measurement results (AA-MRI). The four methods of intraoperative measurement were: Junior visualization (AA-JV), the intersection angle between the line connecting the center of the popliteal fossa and the contact center of the plaster frame and the line connecting the two ischial tuberosities; the same methods as method one by Senior visualization (AA-SV); the intersection angle between the line connecting the center of the popliteal fossa and the center of the anus and the line connecting the ischial tubercle (anus-popliteal, AA-AP); the intersection of the vertical line between the center of the popliteal fossa and the groin and the horizontal line of the center of the anus and the vertical line connecting the two ischial tuberosities intersect (anus-groin crease-popliteal, AA-AGCP). The t-test, correlation coefficient, linear regression and Bland-Altman test were used to evaluate the measurements. Results:Comparing the four intraoperative and postoperative AA-MRI measurement methods, AA-JV (42.69°±4.13°) < AA-SV (44.80°±4.08°) < AA-AGCP (46.25°±5.15°) < AA-MRI (47.68°±4.21°) < AA-AP (51.77°±5.30°), and the difference between AA-JV and AA-SV, AA-AP and AA-AGCP was statistically significant ( t=2.53, P=0.013; t=5.47, P=0.001), there was no significant difference between AA-AGCP and AA-MRI ( t=1.57, P=0.118). The inter-group agreement of the five methods ICC test ranged from 0.807 to 0.892, and the intra-group average agreement of AA-MRI was 0.948. All ICC results were greater than 0.75 with good agreement. Linear regression results showed that the four intraoperative measurement methods had a good or moderate linear relationship with AA-MRI, AA-AGCP ( R 2=0.499)>AA-AP ( R 2=0.318)>AA-SV ( R 2=0.253)>AA-JV ( R 2=0.217), AA-AGCP was the best measurement method. The results of Bland-Altman scatterplot of AA-AGCP and AA-MRI were in good agreement, the mean and standard deviation of bias were -0.796±3.247, and the limit of agreement was 95% LoA (-7.16, -5.57). Conclusion:The AA method of visualization before Spica casting was smaller than truth. The method AA-AGCP objectively by landmarks was the advocated means measuring abduction angle during operation with highly consistency, agreement and easily performed.
ABSTRACT
Objective To investigate the shaping rules of the femoral heads in the morphological perspective.The research objects are hips of normal children and children who have developmental dysplasia of the hip(DDH) and after closed reduction or limited open reduction.At the same time measuring and analyzing normal hip femoral head form changing with the children's age.Methods Collecting the DDH cases that after closed reduction and limited open reduction from June 2013 to December 2015.The follow-up period was more than 1 year.MRI images were collected before surgery,6 months after surgery,1 year after surgery,and 2 years after surgery.In addition,normal hip joint MRI images from 0 to 18 years old were collected for controlled study.Descriptive data on the affected side,healthy side and normal hip joint morphology of the hip dislocation were statistically analyzed.Results (1) The mean eccentricity of femoral head in normal hip decreased from (0.362 ±0.069) at 1-2 years to(0.141 ±0.028) at 18-19 years.(2) The eccentricity of femoral head before closed reduction and limited open reduction were both greater than those of healthy side.There was no significant difference in the eccentricity of the femoral head between the healthy side and the affected side at 1 year after closed reduction (P =0.211).There was no significant difference in the diameter of the bilateral femoral heads (P =0.871).The eccentricity of the bilateral femoral heads remained different at 2 years after limited open reduction (P =0.028),and the diameter of the affected femoral head exceeded the healthy side 1 year after surgery (P =0.001).Conclusion The shape of the femoral head of normal children gradually approaches the spherical shape with age.One year after closed reduction of DDH,the shape and size of the affected femoral head are close to the healthy side,and the femoral head of the affected side increases more than the healthy side in 1 ～ 2 years after open reduction and the morphology is still different.
ABSTRACT
Objective:To establish a model of mandibular impact third molar extraction with common dental materials for pre-clinical trai-ning.Methods:Based on the characteristics of the common dental materials,the anatomy and extraction skill of mandibular impact third molar,the dental model for mandibular impact third molar extraction was designed and made.Then,this dental model was placed in the head-simulation model as required,and used by the dentists and the students.The questionnaire was designed and used to evalu-ate the effects of the model.Results:A new method of designing and making a dental model for mandibular impact third molar extraction with the common dental materials was established successfully.The questionnaire results showed that all the dentists and students agreed that this model could simulate the mandibular third molar extraction procedure.Conclusion:Simulation model of the mandibular third molar extraction can help students for the following clinical practice.
ABSTRACT
Objective:To evaluate the efficacy of Piezosurgery in split teeth extractions.Methods:A single-center,randomized,split-mouth study was performed using a consecutive serious of unrelated healthy patients attending the departing of oral and maxillofacial surgery,Peking University School and Hospital of Stomatology.40 patients were selected for extraction of maxillary molars without reservation value,splitting or nonvital teeth.They were divided into control (20 patients)and test groups (20 pa-tients)randomly.Surgical treatments for both groups were under local anesthesia.Molar teeth of control group were extracted by common equipments like dental elevators,chisels,forceps,etc.While molar teeth of experimental group were extracted by Piezosurgery,aided with the use of common equipments if needed.Then we compared the duration of surgery,frequency of the usage of chisels,expansion of post-operative bony socket surgical discomfort and postoperative pain between two groups.Results:The ave-rage of operation time was (629.5 ±171.0)s in control group and (456.0 ±337.2)s in test group.The buccal alveolar bone reduced (1.07 ±0.64)mm in control group and (1.49 ±0.61)mm in test group. There was a significant difference between the two groups (P 0.05).Conclusion:Piezosugery can be better to preserve alveolar bone,re-duce trauma and patient’s fear.Application of the piezosugery reflect the characteristics of minimally in-vasive extraction,which has the value of promotion.The Piezosurgery technique have the advantage of re-ducing change of buccal alveolar bone during the surgery,but a longer surgical time was required when compared with the conventional technique.VAS value of surgical discomfort,expansion of postoperative bony socket and the operative fear rate,there were no significant difference.Minimally invasive tooth ex-traction technique has good clinical results and high satisfaction.Piezosurgery proved its worth as the in-strument adapted to limiting the destruction of bone tissue.
ABSTRACT
Objective:To access the feasibility and safety of application of flexible laryngeal mask air-way ( FLMA) in oral&maxillofacial day surgery. Methods:Retrospective study was conducted of 40 oral& maxillofacial day surgery patients (3 to 61 years of age) using FLMA under general anaesthesia in De-partment of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology. All the patients were with American Society of Anesthesiologists ( ASA ) physical status Ⅰ -Ⅱ, including 19 males and 21 females. The patients' vital signs were recorded at five different time points:baseline before anesthesia ( T0 ) , time right after the FLMA insertion ( T1 ) , time at incision ( T2 ) , 15 min after incision ( T3 ) and time at the end of the operation ( T4 ) . The first attempted FLMA insertion successful rate and the number of timed of changing to endotracheal intubation were recorded. During operation, frequencies of movement, hypoxia and obstruction of airway were noted and the operation time, anesthesia time, time from the end of the operation to extubation, movement and coughing following extubation and sore throat within 24 h were taken down. Operation-related complications of bleeding, hematoma and injury of local nerves were recorded within 24 h as well. Results:The operations of all the 40 patients were successfully done under general anaesthesia. The 36 ( 90%, 36/40 ) patients using FLMA successfully were under steady process, including 16 males and 20 females. The first attempted successful rate of FLMA insertion was 80% (32/40), and the second 50% (4/8). Three out of the 4 failed FLMA patients were changed to endotracheal intubation after the second attempt failed. The other patient was changed to endotracheal intubation before operation because of leak. The average operation time was (46. 58 ± 22. 57) min, the anesthesia time was ( 77 . 97 ± 26 . 82 ) min and the time from the end of operation to extubation was (8. 31 ± 3. 33) min. All the patients were recorded without obvious body movement during the operation procedure. There were 4 patients (11. 11%, 4/36) with slight body movement during extubation. The incidence of sore throat was 13. 89% (5/36) within 24 h postoperatively. There were no complications of bleeding, hematoma and injury of local nerves. The vital signs of baseline T0 were significantly different from those at other time points T1, T2, T3, and T4 (P0. 05). As to the values of systolic blood pressure and diastolic blood pressure after anesthesia at T1 and T4 , T2 and T3, for two-two comparison, there was no statistical difference (P>0. 05). As to the respiratory rate from the start of the surgery, the values at T2, T3 and T4 showed no statistical difference (P>0. 05). Conclusion:Flexible laryngeal mask airway is a supraglottic airway management method. It is suitable and safe for securing the airway in oral & maxillofacial day surgery. The advantages of fewer haemody-namic changes and postoperative complications are confirmed.
ABSTRACT
OBJECTIVE: To present our experience of manipulation under general anesthesia for treating postoperative hip joint stiffness in children.METHODS: 193 children (226 hips) with postoperative joint stiffness were retrospectively studied at the Department of Pediatric Orthopaedics, Shengjing Hospital, China Medical University from January 1978 to December 2005, comprising 53 males and 140 females, aged 1-14 years old. 226 hips with postoperative stiffness from open reduction of developmental dysplasia of the hip (DDH) (155 cases with 188 hips) and capsulotomy for hip sepsis or tuberculosis (38 cases with 38 hips) were retrospectively reviewed. All patients laid on the surgical table supinately under general anesthesia. The assistant fixed the pelvic with palms. The operator manipulated the hip joint with 3 steps: flexed hip joint slowly and gently to 110°-120° or more; then abducted and externally rotated hip joint; adducted and internally rotated the hip. Then 3-step passive manipulation was repeated for once at least. As soon as the patient waked from general anesthesia, Continuous passive motion was applied for the affected hip with the range of motion increasing daily for 1-2 weeks. They were followed averagely 15 months (6-24 months) to evaluate the promoted range of motion in flextion-extension and adduction-abdduction.RESULTS: 186 hips (82.3%) succeeded in manipulation in addition to 34 failure hips (15%) and 6 hips (2.7%) with femoral neck fracture. The successful rate, promoted range of motion in group of ≤6-year-old and group of ≤12-month-duration from primary surgery were significantly higher, femoral neck fracture rate was less than those in group of >6 years of age and group of >12-month-duration from primary surgery.CONCLUSION: Passive manipulation under general anesthesia is a safe, uninvasive and effective method in treating postoperative hip stiffness in children. Younger age (≤6 years) and less duration from the primary surgery (≤12 months) would yield better result.
ABSTRACT
Adenovirus carrying BMP-2 gene, after being mixed with fibrinous gel, was siphoned off on biodegradable scaffolds (PLA/PCL). The composite was used to repair 1.5 cm long radius defect in rabbits. Four methods were in use in the experiments: Ad-BMP-2 plus fibrinous gel and PLA/PCL (Group A), reconstructed hBMP-2 plus fibrinous gel and PLA/PCL (Group B), Ad-Lacz plus fibrinous gel and PLA/PCL (Group C), and fibrinous gel and PLA/PCL (Group D). Results showed that the defects treated in Group A were repaired with much more new bone regenerated, bridged earlier and stronger than those in Group B 12 weeks after operation. The defects treated in the other two groups could not attain osseous tissue healing. BMP-2 gene carried by biodegradable scaffold and fibrinous gel is easy to conduct and has very strong osteoinduction ability. It is really a good method to repair segmental bone defects.
Subject(s)
Animals , Humans , Rabbits , Absorbable Implants , Adenoviridae , Genetics , Metabolism , Biocompatible Materials , Bone Morphogenetic Protein 2 , Genetics , Bone Substitutes , Caprolactam , Chemistry , Fracture Healing , Gels , Genetic Therapy , Implants, Experimental , Lactic Acid , Chemistry , Polyesters , Polymers , Chemistry , Radius Fractures , Therapeutics , Tissue Engineering , Tissue ScaffoldsABSTRACT
Objective To establish a rapid and sensitive method for detection of urinary protein.Methods In B-R buffer solution with pH 4.2,the signals of resonance light scattering by Poncesu S (PS) combined with protein in ?ex=?em=306nm were detected.Results There was a linear relation between the scattering signals of resonance light,and the protein concentration ranged from 0 to-1500 mg/l. The regression equation was ?I=2.24c-0.41,r=0.999 and the detection limit was 1.48 mg/l. The average recovery was 102.8% and the between-and within-subject coefficients of variation were 2.09% and 5.40% respectively.No significant difference was found compared with the method of PS.Conclusion The established method in this study is a simple,rapid and high sensitive method for determination of urinary protein.
ABSTRACT
[Objective]To investigate the expression of collagen type I and III at mRNA and protein level in the ligamentum teres of developmental dislocation of the hip(DDH) and the normal hip. [Method]There were 6 pairs joint laxity of patients of DDH group and normal control group with paired control of same sex and age.Semiquantity RT-PCR method was used to detect the COLlal and COL3al in the ligamentum teres at mRNA level. Western-Blot method was used to detect the COLlal and COL3al in the ligamentum teres at protein level. The quantitative analysis of the COLlal and COL3al were performed by professional image software and the results were analyzed with standard statistical methods.[Result]At both mRNA and protein level COLlal expression were decreased in the DDH group compared to the control group(P0.05).[Conclusion]The decreased collagen I expression at mRNA and protein level in the ligamentum teres of the children with DDH may lead to hip joint laxity.Hip joint laxity in DDH may be independent to the content of collagen III.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the proliferative potential of the epithelial cells in odontogenic keratocyst, radicular cyst, dentigerous cyst and ameloblastoma.</p><p><b>METHODS</b>DNA contents and ploidy of basal and spinous cells in keratocyst, radicular cyst, dentigerous cyst, and the peripheral column cells and central reticular cells in ameloblastoma were analysis respectively.</p><p><b>RESULTS</b>The more and higher DNA contents and the proliferating ploidy of keratocyst and ameloblastoma than those of radicular cyst and dentigerous cyst indicate the active proliferating potential. The spinous cells showed more active proliferating growth than the basal cells of keratocyst. The higher DNA contents of radicular cyst are related to the stimulus of the inflammation. The dentigerous cysts have more di-ploidy cells without active growth potential.</p><p><b>CONCLUSIONS</b>The active cell proliferating growth in keratocyst and ameloblastoma is probably the pathological basis of their local aggressive biological behavior.</p>