ABSTRACT
OBJECTIVE@#To investigate the effect of preoperative condylar condition for mandible retrognathism deformities with severe temporomandibular joint osteoarthrosis on the stability of the jaw after orthognathic surgery and on the postoperative condylar volume changes.@*METHODS@#In this retrospective study, from 2014 to 2019, 37 patients including 1 male and 36 female, aged between 21 to 34 years old with an average age of (28.03±6.52) years, were diagnosed with mandible retrognathism deformities with severe temporomandibular joint osteoarthrosis by Peking University School and Hospital of Stomatology and received orthognathic surgery, meeting the inclusion criteria were included. According to the preoperative condylar condition. There were divided into smooth group and non-smooth group, the lateral cephalometric films 1 week (T0), 3 months (T1), 6 months (T2) and 1 year (T3) after surgery were used to establish the coordinate system and cephalometric analysis to determine the stability of the jaw after operation. The three-dimensional model of the condyle was segmented by cone beam computed tomography (CBCT) 1 week (T0), 3 months (T1), 6 months (T2) and 1 year (T3) after surgery and the volume was obtained to evaluate the change of the condyle volume after surgery. CBCT image data was used to evaluate the changes of the condylar condition after surgery, and to clarify the correlation between the postoperative condylar condition and jaw stability. SPSS 20.0 statistical software was used for statistical analysis, Fisher's exact probability methods were used to compare whether there were statistically significant differences in the stability of the mandibular joint at stages T1, T2 and T3 with different preoperative condylar condition.Spearman correlation coefficient analysis and Mann-Whitney test were used to compare whether there were statistically significant differences in the volume changes at stages T1, T2 and T3 after surgery between the two groups.@*RESULTS@#The recurrence rates of the mandible in the condylar smooth group were T1 36.85%, T2 47.37% and T3 42.11%, respectively. The recurrence rates in the non-smooth condylar group were T1 27.78%, T2 44.44% and T3 55.56%, respectively. There was no statistical difference in the recurrence rates between the two groups at different time points. There was no significant difference in the condylar volume change between smooth group and non-smooth group.@*CONCLUSION@#For patients with mandible retrognathism deformities with severe temporomandibular joint osteoarthrosis and no significant changes in the condyle observed for one year before surgery, there is no difference in the influence of the preoperative condylar condition on the stability of jaw after operation, and no definite influence on the volume of the condyle after operation. Condylar resorption 3 months after surgery can cause instability of the jaw after orthognathic surgery.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Cone-Beam Computed Tomography , Mandible , Mandibular Condyle , Orthognathic Surgery , Osteoarthritis/surgery , Retrospective Studies , Temporomandibular Joint/surgeryABSTRACT
Objective: To investigate the bioactive chemical constituents of the aerial parts of Eclipta prostrata. Methods: The compounds were isolated and purified by macroporous absorption resin, silica gel, Sephadex LH-20 and semi-preparative HPLC chromatography. Their structures were determined by MS and NMR data. The α-glucosidase inhibitory activities of compounds 1 and 2 were tested by in vitro screening assay. Results: A total of eight compounds were isolated from the ethyl acetate partition of the ethanol extract of E. prostrata. They were identified as 7β-hydroxystigmasterol 3-O-β-D-glucopyranoside (1), 7α-hydroxystigmasterol 3-O-β-D-glucopyranoside (2), 7α-hydroxysitosterol 3-O-β-D-glucopyranoside (3), 3β,23-dihydroxy-30-norolean-12,20 (29)-dien-28- oic acid (4), camellenodiol (5), echinocystic acid-3-O-(6-O-acetyl)-β-D-glucopyranoside (6), eclalbasaponin I (7) and eclalbasaponin IV (8). Compound 2 exhibited strong inhibition against α-glucosidase with an IC50 value of (11.7 ± 4.2) μmol/L. Conclusion: Compound 1 is a new compound named eclalbasaponin XIV and compounds 3-5 are reported from this herb for the first time. Steroidal glycosides could be the anti-hyperglycaemic components in E. prostrata by inhibiting α-glucosidase.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the indications, safety and difficulties of one stage thyroidectomy and bilateral neck lymph node dissection for well-differentiated thyroid carcinoma.</p><p><b>METHODS</b>A retrospective review was carried out in 36 well-differentiated thyroid carcinoma patients so treated from 1990 to 2004. Various incisions including H, L and modified Kocher types were selected according to the location of primary tumor and status of cervical lymph node metastasis. Either total thyroidectomy or sub-total thyroidectomy combined with bilateral neck lymph node dissection according to the principles of modified radical neck lymph node dissection: preserving the internal jugular vein, spinal accessory nerve and sternocleidomastoid muscles.</p><p><b>RESULTS</b>There was no operative death in this group. Postoperative complications included: 2 wound bleeding, 3 recurrent laryngeal nerve resection due to tumor involvement, 1 recurrent laryngeal nerve injury, 2 unilateral internal branch of superior laryngeal nerve injury, 9 unilateral external branch of superior laryngeal nerve injury, 3 unilateral accessory nerve injury, 5 unilateral sympathetic nerve injury, 2 unilateral phrenic nerve injury, 6 chylus fistula, 13 temporary hypoparathyroidism, 2 permanent hypoparathyroidism. The dissected lymph nodes were found to be positive from 0 to 21 in each patient with a mean of 8.3. Of the 36 patients: 31 had bilateral positive lymph nodes; 3 unilateral positive; 2 bilateral negative lymph nodes. The follow up period ranged from 1 to 13 years, Three patients died of distant metastasis, 1 died of cerebral vascular accident. 7 patients lost in follow-up. Totally, 25 patients are still alive, 3 patients had local relapse and were surgically treated again.</p><p><b>CONCLUSION</b>The procedure of one-stage thyroidectomy and bilateral neck lymph node dissection for well-differentiated thyroid carcinoma is safe, as it is mandatory that at least one unilateral internal jugular vein should be preserved; one unilateral recurrent laryngeal nerves and accessory nerves should not be injured. Well-differentiated thyroid carcinoma patients whose bilateral cervical lymph nodes are clinically suspected to be positive (obviously enlarged, hard, purplish grapelike lymph node) or are confirmed pathologically to be positive are indications for one-stage thyroidectomy and bilateral neck lymph node dissection. Total or sub-total thyroidectomy should be undertaken with emphasis that at least one parathyroid with blood supply should be preserved. It is of utmost importance that not only the cancer be completely resected but the function of the organs be preserved.</p>