ABSTRACT
OBJECTIVE: To examine the effectiveness of Chinese medicine (CM) Lianhua Qingwen Granule (LHQW) and Jingyin Gubiao Prescription (JYGB) in asymptomatic or mild patients with Omicron infection in the shelter hospital. METHODS: This single-center retrospective cohort study was conducted in the largest shelter hospital in Shanghai, China, from April 10, 2022 to May 30, 2022. A total of 56,244 asymptomatic and mild Omicron cases were included and divided into 4 groups, i.e., non-administration group (23,702 cases), LHQW group (11,576 cases), JYGB group (12,112 cases), and dual combination of LHQW and JYGB group (8,854 cases). The length of stay (LOS) in the hospital was used to assess the effectiveness of LHQW and JYGB treatment on Omicron infection. RESULTS: Patients aged 41-60 years, with nadir threshold cycle (CT) value of N gene <25, or those fully vaccinated preferred to receive CM therapy. Before or after propensity score matching (PSM), the multiple linear regression showed that LHQW and JYGB treatment were independent influence factors of LOS (both P<0.001). After PSM, there were significant differences in LOS between the LHQW/JYGB combination and the other groups (P<0.01). The results of factorial design ANOVA proved that the LHQW/JYGB combination therapy synergistically shortened LOS (P=0.032). CONCLUSIONS: Patients with a nadir CT value <25 were more likely to accept CM. The LHQW/JYGB combination therapy could shorten the LOS of Omicron-infected individuals in an isolated environment.
ABSTRACT
PURPOSE: To evaluate transverse displacement of the proximal segment after bilateral sagittal split ramus osteotomy (BSSO) advancement with different lingual split patterns and advancement amounts and to determine the influential factors related to mandibular width. MATERIALS AND METHODS: A 3-dimensional finite element model of the mandible including the temporomandibular joint was created for a presurgical simulation and for BSSO with lingual split patterns I (T1; Hunsuck split) and II (T2; Obwegeser split). The mandible was advanced 3 mm (A3) and 8 mm (A8) and fixated with a conventional titanium plate. Ansys software was used to measure the linear distances of the interproximal segments and to analyze the transverse displacement distribution of proximal segments after applying the load of masticatory muscle force groups. RESULTS: After surgical simulation, T1A3, T1A8, T2A3, and T2A8 showed increased transverse widths (mean, 2.99, 4.70, 2.36, and 4.42 mm, respectively). For transverse augmentation, there was a statistically significant difference between the 2 different mandibular advancement amounts in T1 and in T2 (P ≤ .000), but no significant differences was observed between T1 and T2 (P ≥ .058). The maximum transverse displacement distribution in the proximal segment was measured around the gonial area, and the early contact area was found near the border between the horizontal and sagittal osteotomy lines. CONCLUSION: Transverse displacements of proximal segments occur after BSSO advancement with T1 and T2 and transverse augmentation has statistically meaningful effects depending on the amount of advancement; however, no differences in transverse augmentation between T1 and T2 were identified. The fulcrum caused by the early contact between the proximal and distal segments could be an influential factor related to mandibular width.
Subject(s)
Mandible/anatomy & histology , Mandible/surgery , Mandibular Advancement/methods , Osteotomy, Sagittal Split Ramus/methods , Computer Simulation , Finite Element Analysis , Humans , Imaging, Three-Dimensional , Mandible/diagnostic imaging , Models, Anatomic , Outcome Assessment, Health Care , Preoperative PeriodABSTRACT
OBJECTIVE: To improve the accuracy and safety of the Le Fort I osteotomy. METHODS: Eighty-four patients underwent CBCT scan before maxillary orthognathic surgery. The anatomic structures of maxilla were marked and measured. RESULTS: In 84 cases, there were 3 cases with severe hypoplasia of maxillary sinus, 11 cases with impacted third molar, 8 cases with separation in maxillary sinus, 4 cases with the deviation of nasal septum, and 3 cases with cysts in maxillary sinus. Form CBCT images, the position of the pterygopalatine canal, the thickness of maxillary wall, hidden lesion of maxillary sinus, the location of Impacted molar, the deviation of nasal septum, and other anatomic structure could be accurately localized. CBCT could provide sufficient and valuable information in diagnosis and design for Le Fort I osteotomy. CONCLUSIONS: CBCT imaging technology could provide precise anatomic images for Le Fort I osteotomy. It improves the accuracy and safety of the Le Fort I osteotomy.
Subject(s)
Osteotomy, Le Fort/methods , Tomography, X-Ray Computed/methods , Adolescent , Adult , Female , Humans , Male , Young AdultABSTRACT
OBJECTIVE: To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP). METHODS: 3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied. RESULTS: The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy. CONCLUSION: 3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.