上颌骨改良Le FortⅠ型截骨术的三维建模和术后咬合有限元分析

目的根据CT扫描数据,基于4种软件建立光顺的上颌骨三维几何模型,模拟改良Le FortⅠ型截骨术及固定方案,对患者术后咬合情况进行有限元分析。方法使用Mimics软件初步处理CT图像,建立STL模型。将模型导入Inspire Studio软件中,建立光滑的PolyNURBS几何模型。使用SpaceClaim软件,模拟手术截骨及钛板、钛钉固定方案。使用ANSYS Workbench软件,对术后患者咬合情况进行三维有限元分析。结果仿真结果显示,在磨牙咬合状态下有限元模型的连接关系建立准确无误。在共计6 N的咬合力作用下,钛板最大等效应力为73 MPa。结论本研究采用的上颌骨建模和分析方法可获得适用于仿真分析的光滑几何模型,有限元分析结果可以为各类正颌手术的固定方案提供参考。

成人骨性Ⅲ类错畸形伴面中份发育不足的治疗进展

成人骨性Ⅲ类错畸形伴面中份发育不足的矫治是正颌外科中的重点和难点。这种畸形不仅影响患者口颌系统的正常功能,同时影响面部美观,不利于患者长期生理和心理健康。上颌骨Le FortⅠ型骨切开术是正颌外科矫治上颌骨发育不足的常用术式,常用于重新定位上颌骨的三维空间位置。然而,传统Le FortⅠ型骨切开术难以同时兼顾颜面美观与口颌系统功能的矫治。本文就成人骨性Ⅲ类错畸形伴面中份发育不足的治疗追踪了国内外临床研究进展,为一次性解决颌面部多部位的功能及美学缺陷提供借鉴和参考。

Effects of Different Exogenous Substances on Seed Germination of Isatis indigotica Under Drought Stress and Chemical Composition of Isatis indigotica leaves

This study was to investigate the effects of three exogenous substances on chemical constituents of Isatis indigotica leavesand their efficacy in alleviating drought stress, and explore the methods of applying exogenous substances to efficient cultivationof Isatis indigotica. Polyethylene glycol (PEG) was used to simulate drought stress to deal with seeds of Isatis indigotica at thegermination stage (concentration: 0, 10%, 15%, and 20%). Simultaneous operation of exogenous growth regulators [microbialinoculum (MI), γ-aminobutyric acid (GABA) and salicylic acid (SA)] and PEG were implemented in seeds of Isatis indigotica.The effects of drought stress and the mitigation of exogenous substances were observed by statistics of seed germination potential,germination rate, hypocotyl length, and radicle length of each treatment. The effects of exogenous substances on the content ofalkaloids, crude protein and free amino acids in the leaves of Isatis indigotica grown in a greenhouse were determined after sprayingexogenous substances on the plants. The differences of germination potential, germination rate, hypocotyl length, and radicle lengthamong 15% PEG stress treatment, 10% PEG stress treatment and the control were significant (P<0.05). According to the predesignedgermination standard, the seeds did not germinate under 20% PEG stress treatment. When the PEG concentration was 15%, the resultsof seed germination potential and germination rate after adding MI were significantly different from those under stress alone (P<0.05).When exposed to 10% PEG stress, the supplementation of GABA led to a notable increase in radicle length of Isatis indigotica seeds,showing significant differences compared to other three treatments. The application of MI and GABA under 15% PEG stress resultedin a significant increase in the radicle and hypocotyl length of Isatis indigotica seeds compared to other two treatments. The contentof the total alkaloids in leaves of Isatis indigotica was significantly increased after spraying GABA. Meanwhile, the contents of crudeprotein and the total free amino acids were kept constant after spraying exogenous substances. Application of MI and GABA couldalleviate drought stress of Isatis indigotica. The content of the total alkaloids in leaves of Isatis indigotica could significantly increaseafter spraying GABA.

上颌Le FortⅠ前徙术与前份根尖下截骨后退术术后软组织变化的比较研究

目的测量不同上颌骨正颌术式前后鼻唇区域软组织变化,分析可能导致变化的因素。方法2017—2021年于四川大学华西口腔医院正颌及关节外科住院行正颌手术的患者37例,其中因上颌后缩行上颌骨Le FortⅠ型骨切开前徙术(LFIA)的患者18例,因上颌前突行上颌骨前份根尖下截骨后退术(AMOS)的患者19例。收集其术前即刻和术后6~12个月的螺旋CT影像,通过Mimics和3-Matic软件进行三维重建和匹配,测量软硬组织标志点变化。使用GraphPad Prism软件进行统计学分析,显著性水平α=0.05。结果2种术式术后最主要的软组织变化均发生在上唇区域且改变方向与骨组织移动方向相同。在前后向软组织改变上,LFIA组软硬组织改变的比例为0.628,而AMOS组为0.465。颊部和鼻尖软组织在2种术式后均发生了前移,其中AMDS组中颊部软组织前移的量与软组织厚度的改变具有显著正相关性。在垂直向软组织变化上,LFIA组鼻尖点发生上抬且其距离与颌骨前徙距离具有显著正相关性,AMOS组上唇缘点发生下降且其距离与颌骨后退距离具有显著正相关性。在水平向软组织变化上,鼻翼宽度在行2种术式后均出现增宽,但在AMOS组中鼻翼宽度增宽量与后退距离呈显著负相关。结论AMOS和LFIA术后的鼻唇区域软组织改变与颌骨移动量及方向具有显著相关性。上唇前后向改变与颌骨移动距离具有显著正相关性,鼻翼宽度改变与上颌骨后退距离具有相关性。以上相关性的发现可能帮助临床医生更准确地判断鼻唇区域的软硬组织改变。

基于解剖标志的鼻翼基底缩窄缝合术对正颌患者术后鼻唇部形态的影响

目的:评价基于鼻肌肉解剖结构行鼻翼基底缩窄缝合术(alar base cinch suture,ABCS)对于骨性Ⅲ类牙颌面畸形患者行上颌Le FortⅠ型截骨术后鼻唇部三维形态的影响。方法:选取2019年8月至2020年1月于北京大学口腔医院颌面外科行正颌外科手术的骨性Ⅲ类牙颌面畸形患者30例,其中男性11例,女性19例,平均年龄(23.23±2.98)岁,上颌骨前徙量≤4 mm,依随机数字表法分成试验组和对照组,试验组采用鼻底肌群标记、对位缝合法,对照组采用鼻底肌群拉拢悬吊缝合法。使用3dMD face系统分别在术前及术后至少6个月拍摄患者面部三维照片,在3dMD patient软件上手工标记鼻唇部软组织特征点,分别测量特征点的直线距离、曲线距离、角度、鼻深-鼻翼宽指数等14个指标。使用SPSS 22.0软件进行手术前后数据的分析与对比。结果:两组患者术后上唇皮肤高度、鼻深-鼻翼宽指数变化率之间差异有统计学意义(P=0.023,P=0.012),对照组患者术后上唇皮肤高度增加率、鼻深-鼻翼宽指数减小率均大于试验组,试验组与对照组患者术后鼻翼宽度、鼻翼基底宽度均增大,差异均有统计学意义(P<0.05),对照组患者术后鼻唇角较正常值偏大(P=0.036),试验组患者术后鼻唇角与正常值相比差异无统计学意义。结论:基于解剖标志的ABCS与传统缝合方式相比,对于上颌骨轻至中度前徙时患者术后的鼻部协调性及鼻唇部形态更有利,其在可操作性及客观准确性上亦有一定优势,可成为更优化、精确的ABCS术式在临床中推广应用。

上颌Le Fort Ⅰ型截骨术对鼻形态影响的研究进展

上颌Le Fort Ⅰ型截骨术是正颌外科中矫治上颌骨畸形最常采用术式之一。但是,上颌骨的移动、肌肉的剥离会影响周围软组织的形态,其中鼻形态的改变越来越受到重视。已有研究报道,正颌手术后鼻形态的不利改变是降低患者手术满意度的主要原因之一。明确上颌Le Fort Ⅰ型截骨术对鼻形态的影响能够帮助医生更准确地预测术后鼻形态的变化,从而优化手术设计、提高医患沟通效率。本文将对上颌Le Fort Ⅰ型截骨术后鼻部形态变化的研究进展作一综述,旨在为临床实践提供相应的参考。

上颌骨Le Fort Ⅰ型截骨术后上颌窦炎的研究现状

上颌窦炎是Le Fort Ⅰ型截骨术后常见的并发症,对正颌术后的骨质愈合等非常不利。明确Le Fort Ⅰ型截骨术后上颌窦炎发生的相关因素,针对性采取预防措施,早期发现与及时治疗,对于降低上颌窦炎的发生率,加快患者术后康复,以及提升患者术后生活质量具有重要意义。本文就上颌骨Le Fort Ⅰ型截骨术后并发上颌窦炎的影响、病因、诊断、治疗和预防等进行总结,为正颌外科相关医护人员早期诊治上颌窦炎提供参考。

改良鼻旁植骨减少Le FortⅠ型截骨术后上颌骨垂直向复发的探讨

目的:探讨改良鼻旁植骨是否能减少Le Fort 1型截骨下降手术术后上颌骨垂直向的复发。方法:选择双颌手术中上颌骨下降幅度>3 mm的患者30例,分为改良鼻旁植骨组和非改良鼻旁植骨组。利用术前(T0)、术后3天(T1)和术后6个月(T2)的颌面CT数据对上颌骨位置进行三维测量;同时利用T1与T2的CT数据计算植骨块厚度的变化。采用SPSS 22.0软件包对数据进行统计学分析。结果:术后6个月,在垂直方向上,改良鼻旁植骨组上切牙点复发量为(0.54±0.35)mm,非改良鼻旁植骨组上切牙点复发量为(1.18±0.76)mm(P=0.3997)。2组在前后、水平方向的复发率无显著差异。改良鼻旁植骨组的植骨块厚度降低(11.75±6.25)%,非改良鼻旁植骨组的植骨块厚度降低(33.77±11.56)%(P<0.0001)。结果:改良鼻旁植骨可有效减少植骨块吸收,以及术后上颌骨垂直向复发。

LipoCol Forte capsules reduce the risk of liver cancer:A propensity score-matched,nationwide,population-based cohort study

BACKGROUND Liver cancer is among the top five most common cancers globally. Lipid-lowering drugs such as statins can lower the risk of liver cancer, but may also cause liver damage. LipoCol Forte capsules(LFC), a red yeast rice product, have demonstrated significant antihypercholesterolemic effects and a good safety profile in clinical studies.AIM To evaluate whether LFC lowers the risk of liver cancer in adults in this propensity score-matched, nationwide, population-based cohort study.METHODS We used data from Taiwan’s National Health Insurance Research Database, which includes electronic medical records for up to 99.99% of Taiwan’s population. LFC users and LFC non-users were matched 1:1 by propensity scores between January 2010 and December 2017. All had followup data for at least 1 year. Statistical analyses compared demographic distributions including sex, age, comorbidities, and prescribed medications. Cox regression analyses estimated adjusted hazard ratios(aHRs) after adjusting for potential confounders.RESULTS We enrolled 33231 LFC users and 33231 non-LFC users(controls). No significant differences between the study cohorts were identified regarding comorbidities and medications [standardized mean difference(SMD) < 0.05]. At follow-up, the overall incidence of liver cancer was significantly lower in the LFC cohort compared with controls [aHR 0.91;95% confidence interval(CI): 0.86-0.95;P < 0.001]. The risk of liver cancer was significantly reduced in both females(aHR 0.87;95%CI: 0.8-0.94;P < 0.001) and males(aHR 0.93;95%CI: 0.87-0.98;P < 0.01) in the LFC cohort compared with their counterparts in the non-LFC cohort. The antitumor protective effects applied to patients with comorbidities(including hypertension, ischemic stroke, diabetes mellitus, hyperlipidemia, hepatitis B infection and hepatitis C infection). Those using LFC for more than 84 drug days had a 0.64-fold lower risk of liver cancer compared with controls(P < 0.001). Compared with controls, the risk of developing liver cancer in the LFC cohort progressively decreased over time;the lowest incidence of liver cancer occurred in LFC users followed-up for more than 6 years(27.44 vs 31.49 per 1,000 person-years;aHR 0.75;95%CI: 0.68-0.82;P < 0.001).CONCLUSION This retrospective cohort study indicates that LFC has a significantly protective effect on lowering the risk of liver cancer, in a dose-dependent and time-dependent manner.

含参广义向量均衡问题系统解的通有稳定性

目的对含参广义向量均衡问题系统解的通有稳定性进行研究。方法在支付函数受参数扰动的情况下,通过定义2个系统之间的距离,结合集值映射的上半C-连续性、C-凸性以及Fort定理进行研究。结果与结论证明了(W,ρ)是一个完备度量空间,含参广义向量均衡问题系统解映射是上半连续且具紧值的,以及含参广义向量均衡问题系统解的通有稳定性。

Maredamare 2023:The international beachwear show

A three-day show entirely dedicated to beachwear and resortwear.From July 22 to 24,the sixteenth edition of Maredamare,the international trade show organized and promoted by Underbeach,will be held in the splendid Fortezza da Basso in Florence,Italy,previewing more than two hundred and fifty beachwear collections for summer 2024.Indoor and outdoor events,fashion shows,the presentation of new trends and an area dedicated to sustainability will be on the program.

Agent Blue: A Secret Military and Environmental Chemical Weapon Used for Food Denial in South Vietnam during the Vietnam Civil War (1962-1965)

During the last 60 years, the southern Vietnam environment and Vietnamese living in the Mekong Delta have bio-accumulated arsenic from natural and anthropic (Vietnam Civil War (1962-1965)) sources via their drinking water (groundwater from tube wells) and food supply leading to an increasing risk of chronic poisoning over time. A synthesis and analysis of publications and records is presented to document the Republic of Vietnam (RV), the official name of the South Vietnam Government, and United States (US) militaries contribution to arsenic levels and toxic spikes in the Vietnam Mekong Delta groundwater. During the Vietnam Civil War, Agent Blue, in powder form, was shipped to Port Saigon, via the Saigon River, and transported to the Tan Son Nhut Air Force base during the Vietnam Civil War. After the official start of the American-Vietnam War (1965-1973) the tactical herbicides were re-routed to Bien Hoa Air Force base (1965 to 1971). Approximately 3.2 million liters of Agent Blue (468,008 kg As) was sprayed or dumped by the RV military with the assistance and support of the Central Intelligence (CIA), US Army and US Navy, during the 1962-1965 Khai Huang (Hamlet) Program. A portion of an additional 4.6 million liters of Agent Blue (664,392 kg of As) was sprayed between 1962 and 1965 by the US Air Force as part of Operation Ranch Hand and prior to the official start of the American-Vietnam War in August 1964. Operation Rand Hand began in 1962 and ended in 1971. The Institute of Medicine estimated a total of 7.8 million liters (1,132,400 kg As) of Agent Blue was applied to southern Vietnam landscape from 1962 to 1971. This total includes both the 1962 to 1965 RV Khai Huang program with the assistance of the CIA, US Army and US Navy, and the total Agent Blue applied by US Air Force Operation Ranch Hand from 1962 to 1971. The primary objective of this study was to document how Agent Blue, the arsenic-based herbicide, became a secret US military and environmental chemical weapon used by the RV and US militaries in southern Vietnam during the Vietnam Civil War years (1962-1965). This assessment found that the anthropic arsenic, including Agent Blue, added a toxic burden to the Mekong Delta soils, surface water, groundwater, drinking water, food supply, and human health. However, there are missing details regarding political decisions and a full accounting of the geographic locations sprayed and amount of Agent Blue used. Vietnam War Archives have paper correspondence and RV herbicide spray records that shed greater light on this period. These records are over 50 years old and need to be electronically scanned, stored, and made available for additional historical analyses.

Review and Analysis: Did the United States Transport, Off-Load and Use Commercial 2,4,5-T Herbicides with Unknown Amounts of Dioxin TCDD on Military Base Grounds in Panama Canal Zone between 1948 and 1999?

The 84 km Panama Canal connecting the Atlantic and Pacific oceans has historically been a strategic waterway for shipping and the location of United States (US) military bases. Since the construction of Lake Gatun reservoir, canal locks and navigation channel through the Isthmus of Panama tropical forests in the 1910s, chemicals, pesticides, and herbicides have been essential for controlling upland and wetland vegetation as well as managing mosquito-borne diseases. Chemicals and pesticides flowed into Lake Gatun via land surface runoff and subsurface drainage either attached to the sediment or in solution during the rainy season. Lake Gatun and the Panama Canal was the drinking water source for most of the civilian and military population living in the Panama Canal Zone. Between 1948 and 1999, US military base commanders had the ability to order, from the Federal Supply Catalog, commercially available herbicide 2,4,5-T with unknown amounts of dioxin TCDD for use on the military base grounds in the Panama Canal Zone. The herbicide 2,4,5-T was transported to Panama Canal Zone ports, including the ports Cristobal on the Caribbean and Balboa on the Pacific, and distributed to the US military bases in Panama by rail or truck. The US National Toxicology Program and the International Agency for the Research on Cancer listed dioxin and TCDD as known human carcinogens. Dioxins are endocrine disrupters and can cause certain chloracne, cancers, developmental and reproductive effects. In 1985, the United States government banned the manufacture of the herbicide 2,4,5-T, with unknown amounts of dioxin TCDD, after it was shown to cause cancer in animals. The objectives of this study are to determine: 1) the fate of dioxin TCDD, a contaminant in the herbicide 2,4,5-T, sprayed on the US military base vegetation in the Panama Canal Zone from 1948 to 1999, 2) the transport of dioxin TCDD rich sediment via soil erosion and overland flow into Lake Gatun and Panama Canal waterways and 3) the human health impacts of dioxin TCDD, a known carcinogen, on US military and Panamanian civilians exposed to dioxin TCDD in the Panama Canal Zone.

四川盆地志留系龙马溪组页岩与美国Fort Worth盆地石炭系Barnett组页岩地质特征对比

从沉积学、地球化学、生烃演化、构造演化等方面，对美国Fort Worth盆地石炭系Barnett页岩和四川盆地下志留统龙马溪组页岩进行了对比性研究，发现四川盆地志留系，特别是川南志留系页岩气具有较好的勘探前景。2套烃源岩共性与个性共存，具有相似的沉积背景、厚度、有机质类型（Ⅰ～Ⅱ1）和生烃演化史。但是，Barnett页岩TOC值较高（3％～13％）、相对富集脆性矿物、页岩的微孔隙发育；龙马溪组页岩埋藏较深（一般2000-4000m）、相对富集粘土矿物，且具有较高的成熟度（普遍R0〉2％）、较大的隆升幅度和较快的隆升速率（3000m／80Ma）。

高位Le FortⅠ型截骨同期牙槽嵴裂植骨矫治唇腭裂术后面中部畸形

目的 探讨联合应用高位Le Fort Ⅰ型截骨同期牙槽嵴裂植骨矫治唇腭裂术后面中部畸形的可行性。方法2002年1月～2005年1月，共收治10例唇腭裂术后面中部畸形患者，男4例，女6例。年龄16～32岁。单侧唇腭裂8例，双侧2例。影像学检查均有继发面中部畸形的主要表现。均采用高位Le Fort Ⅰ型截骨和牙槽嵴裂自体髂骨游离移植一期手术矫正。高位Le Fort Ⅰ型截骨的截骨线在上颌骨前壁比常规Le Fort Ⅰ型截骨线高，最高可达眶下孔下5mm左右，水平截开至颧牙槽嵴处再弧形转向下后方。结果术后伤口均I期愈合。复查头部X线片，所有患者上颌骨位置均得到明显改善。随访6～24个月，牙弓外形良好，X线片示无明显骨质吸收，植骨区密度与周围接近。10例均获得满意面容，其中9例获得良好的牙骀关系。结论高位Le Fort Ⅰ型截骨术不仅可前移上颌骨，还可前移部分眶下区及整个鼻旁区和鼻底，更明显地改善畸形。同期行牙槽嵴裂自体髂骨游离移植，可减少手术次数、降低费用、获得理想效果，是矫治唇腭裂术后面中部继发畸形的一种有效方法。

多片段Le Fort I型截骨矫治严重牙颌面畸形

目的:采用多片段Le Fort I型截骨术矫治严重牙颌面畸形,并为克服术后骨段固位不良之缺点自制一种腭侧固定夹板。方法:以该手术方法联合双侧下颌升支矢状劈开术（BSSRO）矫治上颌宽度不足伴上下颌其它严重畸形的患者19例。采用单纯多片段Le FortI型截骨6例,联合BSSRO13例。19例中上颌两片段Le FortI型截骨12例,3片段7例。结果:术后随访16例,平均22.6m,66间距离平均扩宽7.3mm,33间平均扩宽3.9mm。无严重并发症及明显复发,咬合关系满意。结论:应用良好的腭侧固定夹板,采用多片段 Le FortI截骨联合BSSRO可一次满意矫治严重双颌畸形。

腭侧入路改良Le Fort Ⅰ型截骨术矫正唇腭裂继发上颌骨发育不足的临床初步应用

目的：评价腭侧入路改良Le FortⅠ型截骨术矫正唇腭裂继发上颌骨发育不足畸形的临床效果。方法：选取2012年1月至2013年12月于北京大学口腔医院行腭侧入路改良Le FortⅠ型截骨术矫正唇腭裂继发上颌骨发育不足畸形的11例患者（男性7例,女性4例）,平均年龄21岁（17-28岁）,其中9例患者同期行双侧下颌升支矢状劈开截骨术（bilateral sagittal split ramus osteotomy,BSSRO）和颏成形术以获得良好的容貌。分别于术前、术后即刻、术后6个月时拍摄头颅定位侧位X线片,测量上齿槽座点（A）水平移动量、蝶鞍中心点-鼻根点-上牙槽座点角（angle of sella-nasion-subsipmale,SNA）和蝶鞍中心点-鼻根点-下牙槽座点角（angle of sella-nasion-supramental,SNB）的度数以评价畸形矫正效果。结果：所有患者均顺利完成手术,颌骨畸形矫正效果满意,咬合关系良好。术后即刻上颌骨A点水平前徙量平均为（6.6±1.1）mm,术后6个月时平均为（6.0±1.2）mm。SNA术前平均为75.9°±2.8°,术后即刻时平均为81.6°±8.6°,术后6个月时平均为81.0°±2.6°;SNB术前平均为82.6°±3.7°,术后即刻时平均为78.0°±2.4°,术后6个月时平均为78.5°±2.4°。结论：腭侧入路改良Le FortⅠ型截骨术可成功矫正唇腭裂术后继发上颌骨发育不足畸形,并获得良好的咬合功能;该术式术中解除了腭侧瘢痕组织的牵拉,能使上颌骨前移更充分,可获得满意的临床疗效。