Research progress of 3D printed poly (ether ether ketone) in the reconstruction of craniomaxillofacial bone defects.

The clinical challenge of bone defects in the craniomaxillofacial region, which can lead to significant physiological dysfunction and psychological distress, persists due to the complex and unique anatomy of craniomaxillofacial bones. These critical-sized defects require the use of bone grafts or substitutes for effective reconstruction. However, current biomaterials and methods have specific limitations in meeting the clinical demands for structural reinforcement, mechanical support, exceptional biological performance, and aesthetically pleasing reconstruction of the facial structure. These drawbacks have led to a growing need for novel materials and technologies. The growing development of 3D printing can offer significant advantages to address these issues, as demonstrated by the fabrication of patient-specific bioactive constructs with controlled structural design for complex bone defects in medical applications using this technology. Poly (ether ether ketone) (PEEK), among a number of materials used, is gaining recognition as a feasible substitute for a customized structure that closely resembles natural bone. It has proven to be an excellent, conformable, and 3D-printable material with the potential to replace traditional autografts and titanium implants. However, its biological inertness poses certain limitations. Therefore, this review summarizes the distinctive features of craniomaxillofacial bones and current methods for bone reconstruction, and then focuses on the increasingly applied 3D printed PEEK constructs in this field and an update on the advanced modifications for improved mechanical properties, biological performance, and antibacterial capacity. Exploring the potential of 3D printed PEEK is expected to lead to more cost-effective, biocompatible, and personalized treatment of craniomaxillofacial bone defects in clinical applications.

Modified Adipofascial Internal Mammary Artery Perforator Flap for Secondary Esophagoplasty.

Papillary thyroid carcinoma with esophageal invasion often requires simultaneous reconstruction after radical tumor resection. However, in a recurrent case, with the upper aerodigestive tract previously reconstructed by a free flap, the alternative option for secondary reconstruction still presents a great challenge for surgeons. Here, we describe a novel secondary cervical esophagoplasty technique using a modified adipofascial internal mammary artery perforator flap. The 2-month follow-up postoperatively showed satisfactory patency of the cervical esophagus. The modified adipofascial internal mammary artery perforator flap is a reliable and convenient technique, with better aesthetic results for secondary cervical esophageal reconstruction.

The single-cell stereo-seq reveals region-specific cell subtypes and transcriptome profiling in Arabidopsis leaves.

Understanding the complex functions of plant leaves requires a thorough characterization of discrete cell features. Although single-cell gene expression profiling technologies have been developed, their application in characterizing cell subtypes has not been achieved yet. Here, we present scStereo-seq (single-cell spatial enhanced resolution omics sequencing) that enabled us to show the bona fide single-cell spatial transcriptome profiles of Arabidopsis leaves. Subtle but significant transcriptomic differences between upper and lower epidermal cells have been successfully distinguished. Furthermore, we discovered cell-type-specific gene expression gradients from the main vein to the leaf edge, which led to the finding of distinct spatial developmental trajectories of vascular cells and guard cells. Our study showcases the importance of physical locations of individual cells for exerting complex biological functions in plants and demonstrates that scStereo-seq is a powerful tool to integrate single-cell location and transcriptome information for plant biology study.

Changes in platelet count and coagulation parameters in children with obstructive sleep apnea.

OBJECTIVE: To investigate the correlation between obstructive sleep apnea (OSA) and coagulation status and to speculate on the underlying mechanism in children with OSA. METHODS: We divided 345 children with OSA (age 2-14 years) into four groups according to the apnea-hypopnea index (AHI). We compared platelet (PLT) and coagulation parameters among groups. Correlations between the polysomnography parameters and coagulation parameters were investigated. RESULTS: Children with OSA had higher PLT counts than those without OSA (P < 0.001), while no significant difference was observed in prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombin time, or fibrinogen among children with/without OSA. In linear regression analysis, the AHI and oxygen desaturation index (ODI) presented positive correlation with the PLT count (R2 = 0.155, beta = 0.307, P < 0.001 and R2 = 0.113, beta = 0.262, P < 0.001), and there was no correlation among the AHI, ODI, and other coagulation parameters. The minimum and mean oxygen saturation of arterial blood manifested negative correlation with the PLT count (R2 = 0.076, beta = - 0.116, P = 0.034 and R2 = 0.083, beta = - 0.140, P = 0.008, respectively). CONCLUSIONS: Children with OSA have a higher PLT count, positively correlated with OSA severity, and no evidence of coagulation disorder.

Successful cervicothoracic esophageal stricture treatment with partial sternectomy and a pedicled TAAP flap: A case report.

Postoperative benign esophageal anastomotic leakage and stenosis are common complications after esophagectomy. Treatment options for anastomosis stenosis include endoscopic mechanical dilation, dilation-combined steroid injection, incisional therapy, stent placement, and self-bougienage. However, long-segmental cervicothoracic esophageal stenosis and cutaneous fistula are always refractory to conservative treatments and are clinically challenging. When lesions extend well below the thoracic inlet, transthoracic esophagectomy and alimentary canal reconstruction seem to be the common choice but are susceptible to perioperative mortality and donor-site sequelae, especially for patients with poor health conditions. In this report, we present a novel surgical approach for cervicothoracic esophageal stenosis and fistula via partial sternectomy and reconstruction with a pedicled thoracoacromial artery perforator flap. No recurrence or complications occurred throughout 3 months of follow-up. This case study adds new perspectives to the treatment of anastomotic stenosis.

Sorption of organochlorine pesticides on polyethylene microplastics in soil suspension.

As a new type of environmental pollutant, microplastics (MPs) can adsorb residual organochlorine pesticides (OCPs) in the soil and pose a severe threat to the soil ecosystems. To understand the interaction between soil MPs and OCPs, the sorption of two kinds of OCPs, including hexachlorocyclohexanes (HCHs) and dichlorodiphenyltrichloroethanes (DDTs), on polyethylene (PE) microplastics in soil suspension was studied through sorption kinetics and isotherm models. The effects of solution/soil ratio and MPs diameter on sorption were examined. The kinetic experiment results show that the sorption equilibrium was 12 h， and the sorption process of OCPs on MPs can be well described by a pseudo-second-order model. The Freundlich model (R2 = 0.942-0.997) provides a better fit to the sorption isotherm data than the Langmuir model (R2 = 0.062-0.634), indicating that the sorption process takes place on the nonuniform surface of MPs. The MPs had a good sorption effect on OCPs when the solution/soil ratio was from 75:1 to 100:1. As the diameter of MPs increases, the sorption capacity decreases. These results provide support for further research on microplastic pollution in soil.

Hematological Parameters Characteristics in Children with Obstructive Sleep Apnea with Obesity.

OBJECTIVE: To investigate the possible correlation between obesity and hematological parameters in children with obstructive sleep apnea (OSA). METHODS: A total of 460 children was initially included in our study, which were divided into children with OSA and children without OSA. Multiple analysis was performed for obesity by adjusting confounding factors such as age and gender in 460 children. Further, to minimize the influence of confounding factors and selective bias, propensity score matching (PSM) was performed in children with OSA. Hematological parameters such as inflammatory and coagulable parameters were compared between the normal weight children with OSA and the obese children with OSA following PSM. RESULTS: OSA (OR = 3.061; P<0.001; 95% CI, 1.772-5.288) represented an independent risk factor for obesity. Besides, the obese children with OSA had higher levels of white blood cell (WBC) (P<0.001), neutrophil (NEUT) (P<0.001), neutrophil-lymphocyte ratio (NLR) (P=0.006), fibrinogen (FIB) (P=0.033), while had a lower level of activated partial thromboplastin time (APTT) (P=0.048). No significant differences were observed in other hematological parameters. In linear regression, the results indicated that the levels of WBC (R2 = 0.123, Beta = 0.289, P<0.001), NEUT (R2 = 0.124, Beta = 0.282, P<0.001), NLR (R2 = 0.105, Beta = 0.184, P=0.026) and FIB (R2 = 0.086, Beta = 0.246, P=0.003) were positively correlated with BMI, while the level of APTT (R2 = 0.057, Beta = -0.171, P=0.044) was significantly negatively correlated with BMI. CONCLUSION: OSA was an independent risk factor contributing to obesity. WBC, NEUT, NLR, FIB and APTT are correlated with obesity in children with OSA (aged from 2 to 14 years). These indicators could be used to estimate the status of inflammation and hypercoagulation in the obese children with OSA.

[Analysis of Collision Carcinoma of Larynx Between Moderately Differentiated Squamous Cell Carcinoma and Poorly Differentiated Neuroendocrine Carcinoma from One Case].

A 75-year-old male patient was hospitalized in hoarseness for 2 months. Laryngoscopy showed a mass protruding in right laryngeal chamber and covering the middle part of right vocal cord. Since tumor biopsy showed low differentiation cancer, he received total laryngectomy, and post-operative pathological result found composite carcinoma, which containing medium differentiated squamous cell carcinoma (about 5%) and low differentiated neuroendocrine carcinoma (about 95%). The growth status of tumor indicated it was collision carcinoma. After postoperative regular radiotherapy, no recurrence was found at 6 months of follow-up. The incidence of head and neck collision carcinoma is quite low, and the majority of them occurs in thyroid, which is rare in larynx. The confirmed diagnosis of larynx collision carcinoma is based on postoperative pathological study. The choice of treatment for collision cancer is closely related to the pathological components, the location of the disease and whether there is distant metastasis.

Associations among sleep symptoms, physical examination, and polysomnographic findings in children with obstructive sleep apnea.

PURPOSE: The relationships among PSG findings, OSA symptoms, and tonsil and adenoid size are not clear. In this study, we aimed to investigate the associations between pediatric OSA and tonsil and adenoid size using subjective (OSA-18 questionnaire) and objective (PSG) measurements. METHODS: 101 consecutive patients aged from 2 to 12 years (mean age, 5.4 ± 2.2 years; boys, 72.3%) diagnosed with OSA were enrolled in two age groups (2-6 years group and 7-12 years group) and underwent PSG and lateral cephalometric radiography. Tonsil size and the adenoid-nasopharyngeal (A/N) ratio were determined. Quality of life and sleep symptoms were measured using the Chinese version OSA-18 questionnaire. Demographic and clinical data were obtained. RESULTS: 75 and 26 patients were separately enrolled in 2-6 years group and 7-12 years group. In 2-6 years group, the multiple linear regression revealed that tonsil size and A/N ratio were associated with log apnea-hypopnea index (AHI), and the Spearman's rank correlation reflected a positive correlation between log AHI and the OSA-18 sleep disturbance score (r = 0.362, P = 0.001). Log OSA-18 score was correlated with tonsil size (r = 0.349, P = 0.002) but not the A/N ratio in 2-6 years group. Finally, no significant associations were observed between log OSA-18 scores and log AHI in all patients. CONCLUSION: As PSG stays the golden standard for diagnoses of pediatric OSA, physical examinations and quality-of-life assessments are needed to fully assess the impact of OSA on children.

Peripheral blood immunological parameters of children with adenoid hypertrophy with otitis media with effusion: propensity score matching.

PURPOSE: To evaluate peripheral blood immunological parameters and the possible correlation with age, gender and adenoid size in children with adenoid hypertrophy with OME. METHODS: A total of 664 children with adenoid hypertrophy were initially enrolled in our study, of which 83 had concomitant OME. To minimize selection bias, we performed one to two propensity score matching (PSM) between children with and without OME. After PSM, 80 children with OME (OME group) and 157 children without OME (adenoid hypertrophy [AH] group) were selected. The patients' peripheral blood samples were prepared prior to surgery and their immunological parameters were compared between groups. RESULTS: Compared to the AH group, the serum level of C3 was significantly higher in the OME group (0.88 ± 0.01 g/L vs. 0.94 ± 0.02 g/L; p = 0.014), which was the only independent risk factor for OME (odds ratio 13.58, 95% confidence interval 1.25-147.99; p = 0.032). However, no such difference was seen for serum immunoglobulin (IgG, IgA, IgM, IgE), T cell subsets (CD3+, CD4+ and CD8+ T cells), or lymphocytes and monocytes. Further subgroup analyses showed that in children ≤ 5 years old, the C3 level was significantly higher in OME patients (p = 0.023). A subgroup analysis based on sex indicated that there was a significantly higher level of serum C3 (p = 0.009) and lower CD3+ and CD4+ T cells (p = 0.010 and p = 0.021, respectively) in girls with OME compared to those without OME. No association between immunological parameters and adenoid size was found. CONCLUSIONS: There were no significant differences in cellular immunology and humoral immune indicators in children with adenoid hypertrophy with or without OME. In children ≤ 5 years old, significantly higher serum C3 levels in patients with OME demonstrate excessively activated C3 in comparison to patients without OME. For girls, a higher serum level of C3 with a lower amount of CD3+ and CD4+ T cells may be associated with OME.

Correlations between obstructive sleep apnea and adenotonsillar hypertrophy in children of different weight status.

The present study aimed to evaluate the relationship between OSA and adenotonsillar size in children of different weight status. A total of 451 patients aged 2-13 years with suspected OSA were retrospectively enrolled in the study. Correlations between the apnea-hypopnea index (AHI) and adenotonsillar size in different weight status were investigated. The adenoidal/nasopharyngeal (A/N) ratio of underweight children was significantly higher than that of normal-weight children (P = 0.027). Both adenoid and tonsil size were positively correlated with logAHI in children of normal weight (r = 0.210, P = 0.001; and r = 0.212, P = 0.001) but uncorrelated in the other groups. Gender (OR = 1.49, 95% CI: 1.01-2.20, P = 0.043), obese (OR = 1.93, 95% CI: 1.10-3.40, P = 0.012), A/N ratio (OR = 1.55, 95% CI: 1.28-1.88, P < 0.001) and tonsil size (OR = 1.36, 95% CI: 1.18-1.57, P < 0.001) were all associated with the severity of OSA. Adenotonsillar hypertrophy contributed to OSA in normal-weight children. In children of abnormal weight, instead of treatment for adenotonsillar hypertrophy, appropriate treatments for other factors are required.

Periodontal Disease Is Associated With Increased Risk of Hypertension: A Cross-Sectional Study.

Objective: Published evidence showed that periodontal disease is associated with hypertension. However, relevant findings remain controversial, with few evidences focusing on Chinese population. Therefore, the aim of this study was to investigate the association between periodontal disease and hypertension in Chinese population. Methods: A total of 4,930 participants from an available health examination that was carried out in 2017 were selected for this retrospective study. The correlations between periodontal disease and hypertension were investigated using univariate and multiple logistic regression analyses and propensity score adjusted analysis. Interaction and subgroup analyses were also used to detect variable factors. Results: Finally, a total of 3,952 participants aged 30-68 years were eligible for this study. The results showed that hypertension risk was statistically significant associated with periodontal disease either in unadjusted (OR = 1.28, 95%CI = 1.14-1.47) or in adjusted (OR = 1.34, 95%CI = 1.14-1.58) model. Result from propensity score adjusted analysis also demonstrated a similar association (OR = 1.23, 95%CI = 1.06-1.42). Conclusion: Periodontal disease is significantly and positively correlated with increased risk of hypertension in Chinese population, and exact mechanisms of this association should be explored in future.

Clinical characteristics of internal carotid artery pseudoaneurysms in the sphenoid sinus.

BACKGROUND: Internal carotid artery (ICA) pseudoaneurysms are associated with high mortality if lack of proper management. Patients with ICA pseudoaneurysms in the sphenoid sinus often visit a hospital's ear, nose and throat (ENT) department due to nasal bleeding. In such cases, simple examination and therapy will lead to misdiagnosis. OBJECTIVE: This study sought to investigate the clinical characteristics, diagnostic methods and treatment of ICA pseudoaneurysms in the sphenoid sinus. METHODS: Various data, including clinical features, imaging examination results, and treatment and prognosis information, were collected and analyzed for 8 patients who visited the Department of Otolaryngology, Head & Neck Surgery of West China Hospital from March 2008 to January 2017. RESULTS: The patients included 6 males and 2 females (ages 16 to 56 years). Repeated epistaxis was a common symptom in six of the eight patients (6/8), whereas monocular blindness and binocular blindness were observed in the other two patients. Head trauma was found to play a role in the induction of ICA pseudoaneurysms, given that five patients (5/8) exhibited a specific history of head injury. CT examination tended to result in misdiagnosis, whereas MRI and digital subtraction angiography (DSA) were helpful for obtaining a definite diagnosis with all diagnoses were confirmed via DSA. Coated stent intervention was performed in five patients, while carotid artery ligation was performed in two patients in emergency situations: one of whom exhibited paraplegia, but recovery was ultimately observed after rehabilitation. Moreover, failure of coated stent intervention in one patient was resolved via additional unilateral common carotid artery ligation. Furthermore, one patient with vision loss experienced vision restoration. One patient discontinued treatment for personal reasons and was lost to follow-up. No recurrence was observed in the other 7 patients. CONCLUSION: ICA pseudoaneurysms in the sphenoid sinus are uncommon. To accurately identify ICA pseudoaneurysms, collaboration between otolaryngologists and imaging specialists is essential. On the other hand, both surgical and interventional treatments can achieve good results; therefore, otolaryngologists should enhance their cooperation with neurosurgery and intervention departments. Accurate diagnosis and rapid treatment are keys to managing ICA pseudoaneurysms.