Clinical anatomy of the posterior maxilla pertaining to Le Fort I osteotomy in Thais

This article studies the anatomy of the posterior maxilla pertaining to bone-cut design of Le Fort I osteotomy to avoid the injury to the descending palatine artery in Thais. Fifty-five skulls (38 males, 17 females) were assessed for the anatomical landmarks by a combination of direct inspection, computerized imaging, and computed tomography scan analysis. The results showed that 27.28% of the pterygomaxillary junction (PMJ) became synostosis. The mean heights of the PMJ, posterior maxilla, and maxillary tuberosity were 15.14 +/- 2.46 mm, 22.51 +/- 3.50 mm, and 7.45 +/- 2.76 mm, respectively. The mean length of the medial sinus wall measuring from the piriform rim to the descending palatine canal at the Le Fort I level was 34.40 +/- 2.96 mm. The mean widths of the posterior incision of Le Fort I osteotomy at the maxillary tuberosity and PMJ were 20.38 +/- 2.82 mm and 11.60 +/- 1.57 mm. The mean length of the posterior maxilla was 27.18 +/- 2.49 mm. Distances from the greater palatine foramen to the maxillary tuberosity incision and PMJ incision were 1.76 +/- 1.12 mm and 3.59 +/- 1.40 mm. The mean angle between the descending palatine canal and the hard palate was 57.33 +/- 4.54 degrees . There were no significant differences in any measurements between sides and genders, except the pterygoid process width and posterior maxilla length of males were longer than those of females (P < 0.05). This study could provide better understanding of the posterior maxillary anatomy that is important for the bone-cut design of Le Fort I osteotomy to avoid excessive intraoperative and postoperative hemorrhage including ischemia of the mobilized maxilla.     

不同栽培居群板蓝根性状及显微特征的变异研究

为了探讨菘蓝Ｉｓａｔｉｓ ｉｎｄｉｇｏｔｉｃａ Ｆｏｒｔ．与生药鉴定有关的种内变异,对１９个不同栽培居群的板蓝根样品进行了实验研究。结果表明：不同居群的板蓝根在性状上可分为胶质和粉质两大类,它们的显微组织特征虽基本相同,但淀粉粒的大小、复粒数量占淀粉粒总数的比例不仅在两大类之间有显著差异,不同居群之间也有较明显的差异。聚类分析结果显示：不同栽培居群板蓝根性状特征的改变与淀粉粒特征的改变有关。经异地     

两种外置式牵引治疗严重上颌发育不全

目的：探讨两种外置式牵引治疗严重上颌发育不全的效果。方法：使用自行设计制作的颌骨牵引装置，在全麻下行LeFortⅡ型截骨，将牵引钩置入鼻底或梨状孔侧缘，从鼻孔引出，对8例严重上颌发育不全成年患者前牵引治疗，其中3例采用面弓弹性前牵引，5例采用坚固外固定支架牵引，治疗前后拍摄定位头颅侧位片测量分析。结果：采用坚固外固定支架前牵引治疗的5例患者按术前设计的要求顺利完成牵引成骨，患者咬合关系和软组织侧貌改变明显，上颌平均前移11．6mm。面弓弹性前牵引的3例患者中，1例达到预期效果，2例弹性牵引后效果不明显改为坚固外固定支架前牵引后达到效果，其中1例由于额部因长期压迫出现局部缺血改换为坚固外固定支架。结论：RED是治疗严重上颌后缩畸形的有效方法，对唇腭裂严重上颌发育不全患者慎用面弓弹性牵拉。     

Can use of an administrative database improve accuracy of hospital-reported readmission rates?

Objectives

Readmission rates after cardiac surgery are being used as a quality indicator; they are also being collected by Medicare and are tied to reimbursement. Accurate knowledge of readmission rates may be difficult to achieve because patients may be readmitted to different hospitals. In our area, 81 hospitals share administrative claims data; 28 of these hospitals (from 5 different hospital systems) do cardiac surgery and share Society of Thoracic Surgeons (STS) clinical data. We used these 2 sources to compare the readmissions data for accuracy.

Le Fort Ⅰ型截骨术上抬上颌骨与下颌骨自动旋转中心的相关性研究

目的：探讨Le Fort Ⅰ型截骨术上抬上颌骨后,下颌骨自动旋转中心位置变化与上颌骨上抬距离的关系。方法：选取10例患者．均为上颌骨垂直向发育过度导致开唇露齿和下颌骨后下旋转,而下颌骨发育正常,采用单纯Le Fort Ⅰ型截骨术上抬上颌骨,矫正其牙颌面畸形。拍摄术前、术后头颅定位侧位片,利用Reuleaux法测量实际的下颌骨旋转中心位置．应用SPSS10．0软件包对ANS、PNS上抬量与下颌骨自动旋转中心位置进行Spearman秩相关分析。结果：下颌骨平均自动旋转中心位于蝶鞍点下方49．350mm、后方17．100ram处。髁突中心位于蝶鞍点下方24．000mm、后方11．950mm处。下颌骨自动旋转中心垂直向位置与ANS点的上抬量高度相关（P=0．008）。下颌骨自动旋转中心垂直向位置与PNS点的上抬量高度相关（P=0．045）。结论：下颌骨旋转中心位于髁突外。下颌骨自动旋转中心与上颌骨上抬幅度高度相关。