Traction suture modification to tongue-in-groove caudal septoplasty

Caudal septal deviation leads to unfavorable esthetic as well as functional effects on the nasal airway. A modification to the tongue-in-groove (TIG) technique to correct these caudal septal deformities is described. With placement of a temporary suspension suture to the caudal septum, manual traction is applied, assuring that the caudal septum remains in the midline position while it is being secured with multiple through-and-through, trans-columellar and trans-septal sutures. From 2003 to 2016, 148 patients underwent endonasal septoplasty using this modified technique, with excellent functional and cosmetic outcomes and a revision rate of 1.4%. This modified TIG technique replaces the periosteal suture that secures the caudal septum to the midline nasal crest in the original TIG technique. This simplifies the procedure and minimizes the risk of securing the caudal septum off-midline when used in endonasal septoplasty.     

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??Canted occlusal plane is the main feature of mandibular deviation. The causes of occlusal plane canting are very complicated and inconclusive. A large number of studies have shown that it is related to bite force??bite contact area??chewing movement and even head or neck position. CBCT is the best diagnostic method for assessing occlusal plane canting at present. Canted occlusal plane and mandibular deviation are mainly ipsilateral??and a small number reveals contralateral. It can also have adverse effects on temporomandibular joint and mastication??and it has been difficult to be corrected with non-surgical methods. Based on the existing literature??we summarized the canted occlusal plane features??adverse effects and the commonly used non-surgical treatment methods.     

Associations between serum amino acids and incident type 2 diabetes in Chinese rural adults

Background and aimsSome amino acids (AAs) may be associated with type 2 diabetes (T2DM). This study aimed to determine the associations of individual AAs with the development of T2DM in rural Chinese adults.Methods and resultsA cohort study of 1199 individuals aged 18 years or older was conducted from 2006 to 2008 in a rural community of Deqing, China, a repeated survey was done in 2015 and data linkage with the electronic health records system was performed each year for identifying new T2DM cases. A high-performance liquid chromatography approach was used to measure the baseline serum concentrations of 15 AAs. Cox proportional hazards models were used to examine the associations between AAs and the risk of incident T2DM. A total of 98 new T2DM cases were identified during the follow-up of 12 years on average. Among 15 AAs, proline was associated with an increased risk of incident T2DM after adjusted for age, sex, body mass index, fasting plasma glucose, family history of T2DM, smoking status, alcohol use, and history of hypertension, the adjusted hazard ratio for 1-standard deviation increment was 1.20 (95% confidence interval: 1.00, 1.43). The association tended to be more marked in subjects younger than 60 years and overweight/obese subjects. Among participants without hypertension, proline and phenylalanine were associated with an increased risk of incident T2DM, while aspartic acid was associated with a decreased risk.ConclusionSerum proline was associated with the risk of incident T2DM in rural Chinese adults and might be a potential predictor.     

建立下肢形态学数据库为匹配术后即装假肢提供参考

文题释义： 术后假肢：现代截肢康复的方法包括手术后安装临时假体，即在完成截肢手术后，医生为患者佩戴合适的临时假体。 大腿影像数据：研究采集的大腿数据包括膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径，将大腿MRI数据导入3D重建软件，得到大腿截肢范围段表面积、体积。 大腿截肢范围段：为膝关节间隙上10-25 cm。 背景：目前假肢的制作是通过取型、修型、成型3个步骤完成的，由于修型过程是人工完成，与临床技师的经验技术密切相关，制作出来的假肢不美观，接受腔与残肢很难做到全接触。 目的：收集健康志愿者大腿MRI影像数据，评估成人大腿截肢范围段(膝关节间隙上10-25 cm)的对称性；将MRI影像数据建立成数据库，为下肢截肢患者匹配合适的术后即装假肢提供参考数据。 方法：招募40名健康志愿者，采集基本信息：年龄、身高、体质量、膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径。所有志愿者对试验方案均知情同意，且得到医院伦理委员会批准。对大腿截肢范围进行三维重建，以模型的表面积、体积为参数，对每一例志愿者大腿进行解剖测量，利用三维逆向工程软件对测量结果进行3D偏差分析，完成大腿形态对称性的定量化和可视化分析。 结果与结论：①同体分析：同一个体左右大腿截肢范围段表面积之间的最大百分差异比不超过0.56%(P=0.109)；左右大腿截肢范围段体积之间最大百分差异比不超过1.19%(P=0.182)；三维偏差分析结果显示，最大平均负偏差为-1.47 mm，最大平均正偏差为1.14 mm。40例受试者的3D偏差分布78.02%在2 mm以内，20.97%在2.1-3.0 mm，仅1.01%大于3 mm。②异体分析：三维偏差分析结果显示，最大平均负偏差为-1.97 mm，而最大平均正偏差为1.89 mm。③提示成人双侧大腿截肢范围具有高度的解剖学对称性；当2名成人的膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm周径和膝上缘15 cm处周径分别都相差在2 cm以内时，则认为这2名成人双侧大腿截肢范围段表面轮廓具有高度相似性，与性别、身高和体质量无关。 ORCID: 0000-0001-6838-3042(伍笑棋) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

Impact of ultra-low dose CT acquisition on semi-automated RECIST tool in the evaluation of malignant focal liver lesions

PurposeTo compare the evaluation of malignant focal liver lesions (FLLs) using a semi-automated RECIST tool with a standard and an ultra-low dose (ULD) computed tomography (CT) protocol.Materials and methodsThirty-four patients with malignant FLLs underwent two abdominal-pelvic CT examinations one using a standard protocol and one using an ULD protocol. There were 23 men and 11 women with a mean age 64.3 ± 14.4 (SD) years (range: 22–91 years). Dosimetric indicators were recorded, and effective dose was calculated for both examinations. Mean malignant FLL attenuation, image noise and contrast-to-noise-ratio (CNR) were compared. The largest malignant FLL per patient was evaluated using the semi-automated RECIST tool to determine longest axis length, longest orthogonal axis length, volume and World Health Organisation area.ResultsDosimetric values were significantly reduced by −56% with ULD compared to standard protocol. No differences in mean malignant FLL attenuation values were found between the two protocols. Image noise was significantly increased for all locations (P < 0.05) with ULD compared to standard protocol, and CNR was significantly reduced (P < 0.05). On the 34 malignant FLLs analyzed, six semi-automated shapes non-concordant with radiologist's visual impression were highlighted with the software, including one FLL (1/34; 3%) with standard CT acquisition only, three FLLs (3/34; 9%) with ULD CT acquisition only and two FLLs (2/34; 6%) with both CT acquisitions. After manual editing, the concordance of the values of the studied criteria between both acquisitions was good and no significant difference was reported.ConclusionSemi-automated RECIST tool demonstrates good performances using ULD CT protocol. It could be used in routine clinical practice with a ULD protocol for follow-up studies in patients with known malignant FLL.     

Unbalanced lateral mandibular deviation associated with TMJ sound as a sign in TMJ disc dysfunction diagnosis

The aim was to study the characteristics of lateral mandibular horizontal deviations during opening–closing movements and their association with TMJ sounds of the clicking type. Subjects were 28 healthy volunteers and 38 patients diagnosed with MRI imaging as having TMJ disc dysfunction, 22 with disc displacement without (DD) and 16 as having disc displacement with reduction (DDR). TMJ sounds were recorded with miniature microphones placed in the ear canals, and jaw movements were documented with a kinesiograph. A sign, unbalanced lateral deviation (ubd) was defined as a rapid, short duration, change in jaw movement direction from, and back to, a smooth deviation path in the horizontal plane. The hypotheses were that degrees of maximal deviations, proportions of unbalanced deviation (ubd) and such deviation associated with TMJ sounds (ubdS), differ between healthy subjects and patients with DD or DDR. Comparisons between groups were made using one‐way anova and chi‐square analysis, as appropriate. No differences were found between groups regarding degree of lateral deviation per se. The proportions of ubd and ubdS were significantly higher in patients with DDR than in healthy subjects and than in patients with DD (P < 0·001), but no such differences were found between healthy subjects and patients with DD. For prediction of DDR, the sensitivity and specificity of the sign ubdS were found to be 68·8% and 89·3%, respectively. For the sign ubd, they were 100·0% and 64·3%. This indicates that the sign ubdS has diagnostic value in screening for DDR.     

Relationship between frontal craniofacial morphology and horizontal balance of lip‐closing forces during lip pursing

The objectives of this study were to quantitatively evaluate the relationship between frontal craniofacial morphology and the horizontal balance of the lip‐closing forces (LCF) generated during maximum voluntary pursing‐like movements in patients with mandibular deviation. Thirty‐one subjects (median age 25·4 ± 8·9 years) without a history of orthodontic treatment were randomly selected from among the orthodontic patients who visited our hospital. Lip‐closing forces was recorded in eight directions during maximum voluntary pursing‐like lip‐closing movements. The subjects were divided into the deviation (two males and 11 females) and non‐deviation groups (four males and 14 females). There was no significant difference in the total LCF between the deviation and non‐deviation groups. In the deviation group, the mean LCF value on the deviation side of the upper lip was significantly lower than that detected on the non‐deviation side of the upper lip, while the mean LCF value for the deviation side of the lower lip was significantly higher than that for the non‐deviation side of the lower lip. In contrast, no significant difference in upper or lower lip LCF was detected between the deviation and non‐deviation sides in the non‐deviation group. The difference in the LCF generated in the lower lip between the deviation and non‐deviation sides was significantly positively correlated with mandibular menton deviation and significantly negatively correlated with the difference in maxillary height between the deviation and non‐deviation sides. These results suggest that the horizontal balance of the upper and lower lip LCF produced during pursing‐like lip‐closing movements in patients with mandibular deviation is related to frontal craniofacial morphology.