Mapping out the surgical anatomy of the lingual nerve:a systematic review and meta-analysis

Objectives@#Understanding the lingual nerve’s precise location is crucial to prevent iatrogenic injury. This systematic review seeks to determine the lingual nerve’s most probable topographical location in the posterior mandible. @*Materials and Methods@#Two electronic databases were searched, identifying studies reporting the lingual nerve’s position in the posterior mandible.Anatomical data in the vertical and horizontal dimensions at the retromolar and molar regions were collected for meta-analyses. @*Results@#Of the 2,700 unique records identified, 18 studies were included in this review. In the vertical plane, 8.8% (95% confidence interval [CI], 1.0%-21.7%) and 6.3% (95% CI, 1.9%-12.5%) of the lingual nerves coursed above the alveolar crest at the retromolar and third molar regions. The mean vertical distance between the nerve and the alveolar crest ranged from 12.10 to 4.32 mm at the first to third molar regions. In the horizontal plane, 19.9% (95% CI, 0.0%-62.7%) and 35.2% (95% CI, 13.0%-61.1%) of the lingual nerves were in contact with the lingual plate at the retromolar and third molar regions. @*Conclusion@#This systematic review mapped out the anatomical location of the lingual nerve in the posterior mandible, highlighting regions that warrant additional caution during surgeries to avoid iatrogenic lingual nerve injuries.

Feature Deconstruction Strategy Based Identification of Acute Features Associated With Impairment of Activities of Daily Living in Patients With Traumatic Brain Injury / 中山大学学报(医学科学版)

ObjectiveTo identify acute phase features associated with the prognosis of traumatic brain injury （TBI）. MethodsThrough two traditional strategies， correlation analysis and prediction model， and one innovative research strategy based on feature deconstruction， a retrospective analysis was conducted using demographic， acute phase and chronic phase features of 354 TBI patients to identify acute phase features associated with activities of daily living （ADL） in chronic phase of TBI. For feature deconstruction strategy， the LASSO （Least Absolute Shrinkage and Selection Operator） algorithm was used to build a prediction model that could effectively predict ADL based on non-ADL chronic phase features. The model could indicate the key chronic phase dimensions determining the ADL in TBI patients. We then identified demographic and acute phase variables that were significantly associated with these key chronic phase features. ResultsThe feature deconstruction strategy revealed that ADL could be deconstructed into chronic phase dimensions such as weak limbs in TBI population. Importantly， to the best of our knowledge， this strategy revealed for the first time the association of these important acute phase features with specific chronic phase impairment features. For example， TBI patients had a higher risk for chronic phase recent memory impairment if they had a prolonged coma time and low GCS scores at acute phase ［scaled coma time OR95%CI = 94.288 （35.095， 273.231）； scaled GCS OR95%CI = 0.068 （0.030， 0.147）］； the patients had a higher risk for insight impairment and disorientation at chronic phase if they had hydrocephalus at acute phase ［insight impairment OR95%CI = 6.760 （3.653，12.855） ； disorientation OR95%CI = 6.538 （3.530， 12.490）］. All strategies showed that the strongest risk factors for ADL damage in the chronic phase included prolonged coma time and low GCS scores as well as hydrocephalus. ConclusionThis study provides an innovative research strategy to establish the association between acute injury features and chronic recovery features， and to identify demographic and acute phase features associated with the prognosis of TBI.

Talin1 is highly expressed in the fallopian tube and chorionic villi to promote trophoblast invasion in tubal pregnancy / 南方医科大学学报

OBJECTIVE@#To investigate the expression of Talin1 in the fallopian tube and chorionic villi in patients with tubal pregnancy and its role in regulating invasion and migration of trophoblasts.@*METHODS@#Immunohistochemistry and Western blotting were used to detect the localization and expression level of Talin1 in the fallopian tube and chorionic villi in patients with tubal pregnancy and in women with normal pregnancy. In the cell experiment, HTR-8/SVneo cells was transfected with Talin1 siRNA and the changes in cell invasion and migration were assessed using scratch assay and Transwell assay. The expressions of MMP-2, MMP-9, N-cadherin and Snail in the transfected cells were detected by qRT-PCR and Western blotting.@*RESULTS@#Positive expression of Talin1 was detected in both normal fallopian tube tissues and tissues from women tubal pregnancy, and its expression was localized mainly in the cytoplasm of cilia cells. The expression level of Talin1 was significantly higher in both the fallopian tube and chorionic villi in women with tubal pregnancy than in normal fallopian tube and chorionic villi samples (P < 0.01). In HTR-8/SVneo cells, transfection with Talin1 siRNA significantly inhibited cell invasion (P < 0.01) and migration (P < 0.05), down-regulated the expression of N-cadherin, MMP-2 and Snail (P < 0.05), and up-regulated the expression of MMP-9 in the cells (P < 0.05).@*CONCLUSION@#The expression of Talin1 in the fallopian tube and chorionic villi is significantly increased in women with tubal pregnancy, suggesting the association of Talin1-regulated trophoblast cell invasion with the occurrence of tubal pregnancy.

The Efficacy and Safety Profile of First-line R-CDOPlike Regimen in Diffuse Large B-cell Lymphoma with Cardiovascular Diseases Or High Risk Factors / 中国药学杂志

OBJECTIVE: To evaluate the efficacy and safety profile of first-line R-CDOP(rituximab, cyclophosphamide, pegylated liposomal doxorubicin, vincristine, and prednisone) like regimen in diffuse large B-cell lymphoma (DLBCL) with cardiovascular diseases or risk factors. METHODS: DLBCL Patients who were diagnosed with at least one cardiovascular disease/risk factor and received first-line R-CDOPlike chemotherapy in our institute between January 2010 and November 2016 were collected. Cardiovascular diseases/risk factors were referred as:coronary heart disease, hypertension, age ≥60, hyperlipidemia, diabetes mellitus, obesity, history of smoking, and hypothyroidism/hyperthyroidism. Chemotherapy in our institute were retrospectively reviewed. RESULTS: A total of 94 DLBCL patients were recruited. All enrolled patients had history of a cardiovascular disease or presented a high-risk group of developing cardiovascular diseases:coronary heart disease 10 cases, hypertension 33 cases, hyperlipidemia 44 cases, diabetes mellitus 23 cases, obesity 15 cases, history of smoking 25 cases, hypothyroidism/hyperthyroidism 3 cases. A total of 74 patients had more than one cardiovascular disease or risk factors. A total of 34 patients were germinal center B-cell subtype(GCB) and 60 were non-germinal center B-cell subtype(non-GCB). First-line R-CDOP like chemotherapy was given at a median cycle of 4.5 (range, 2-8). Overall response rate(ORR) and complete response rate (CRR) were 92.6%(87/94) and 70.2%(66/94) for the whole group. 5-Year progression-free survival (PFS) and overall survival(OS) rates were 71.3% and 76.9% for overall. For GCB subtype and non-GCB subtype, 5-year PFS rates were 84.6% and 63.9% respectively(P<0.05), and 5-year OS rates were 80.6% and 74.6%, respectively(P=0.407). Grade III/ neutropenia and thrombocytopenia were documented in 53.2%(50/94) and 3.2% (3/94) of patients. 19 (20.2%) patients developed grade /Ⅱ cardiotoxicity. There was no grade III/ cardiac event causing chemotherapy delay or break off. No further cardiotoxicity occurred neither during follow-up. CONCLUSION: PLD-containing first-line R-CDOP like regimen is demonstrated as a highly effective and much tolerable alternative for DLBCL patients with cardiovascular diseases/risk factors.