Objective To investigate the effect of removing the implanted plate-rod system for scol iosis (PRSS) on maintaining scol iosis curve correction and preserving spinal mobil ity in patients with scol iosis. Methods From June 1998 to February 2002, 119 cases of scol iosis were treated with the implant of PRSS, which was removed 26-68 months later (average46.8 months). Complete follow-up data were obtained in 21 patients, including 6 males and 15 females aged 11-17 years old (average 13.8 years old). The disease course was 9-16 years (average 12.1 years). There were 2 cases of congenital scol iosis and 19 cases of idiopathic scol iosis, which included 5 cases of IA, 2 of IB, 1 of IIA, 2 of IIB, 2 of IIC, 2 of IIIA, 3 of IIIB, and 2 of IVA according to Lenke classification. There were 13 cases of thoracic scol iosis and 8 of thoracolumbar scol iosis. AP view and the lateral and anterior bending view of X-ray films before and at 3 to 6 months after removing PRSS were comparatively analyzed, the coronal and the sagittal Cobb angle were measured, and the height of vertebral body on the concave side and the convex side were measured, so as to know the effect of PRSS on the growth of the vertebral endplates. Results All the implants were removed successfully with an average operation time of 2.5 hours (range 2-4 hours) and a small amount of intraoperative blood loss. Twenty-one cases were followed up for 6-72 months (average 34.4 months). The coronal Cobb angle before and after the removal of PRSS was (20.25 ± 8.25)° and (23.63 ± 8.41)°, respectively, indicating there was no significant difference (P gt; 0.05); while the sagittal Cobb angle was (39.44 ± 12.38)° and (49.94 ± 10.42)°, respectively, indicating there was a significant difference (P lt; 0.05). The height of the top vertebral body on the concave side before and after the removal of PRSS was (1.78 ± 0.40) cm and (2.08 ± 0.35) cm, respectively, and there was a significant difference (P lt; 0.01); while the height on the convex side was (2.16 ± 0.47) cm and (2.18 ± 0.35) cm, respectively, indicating no significant difference was evident (P gt; 0.05). All the 21 patients had good prognosis and no major operative compl ication occurred. Conclusion PRSS is an effective instrumentation for the management of scol iosis. After the removal of the PRSS, the correction of scol iosis can be maintained, and the spinal mobil ity can be protected and restored.
Objective To evaluate the efficacy of 3-dimensional printing model (3DPM) aiding decision making and surgery rehearsal for the treatment of double outlet right ventricle (DORV) with non-committed ventricular septal defect (NC-VSD). Methods From January 1st, 2012 through December 30th, 2014, 12 patients with DORV and NC-VSD were operated with the aid of “3DPM guidance” to do decision making and surgical technique rehearsal preoperatively. There were 9 males and 3 females at age of 2.9±2.2 years. The “3DPM guidance” consisted of step by step procedures: computerized tomography (CT) scan for the patients, CT based 3DPM rendering, 3DPM exploration, decision making, and surgery rehearsal. During surgery rehearsal, surgeons did patch designing, VSD enlargement planning, muscle bundle resection etc. Eight out of the twelve patients underwent biventricular repair, 4 patients underwent single ventricle repair. Six of the eight biventricular repair patients had intra-ventricular baffle repair, 1 patient had intra-ventricular baffle repair and arterial switch procedure, 1 had modified Nikaidoh procedure. VSD enlargement was performed in all the patients in biventricular repair group. The reasons not to do a biventricular repair included very restrictive VSD, tricuspid attachments across the sub-aortic passway. Results The operation findings correlated well with the 3DPM in all the cases. There was no hospital death, no major complication. One patient had a mild sub-aortic stenosis and he was under close follow-up. There was no late death and reoperation. Surgeons involved were satisfied with the “3DPM guidance”. Conclusions 3-D printing model is an excellent way to help decision making for DORV with NC-VSD and can provide surgery simulation which decrease complication rate and help achieve good outcomes.
ObjectiveTo explore the early outcomes of the surgical treatment for patent ductus arteriosus (PDA) combined with intracardiac abnormities via right vertical infra-axillary thoracotomy (RVIAT).MethodsA total of 7 children with PDA combined with intracardiac defects underwent surgery through RVIAT at the Second Affiliated Hospital of Nanjing Medical University from 2016 to 2018. There were 4 males and 3 females, with an average age of 5.3±4.5 years and weight of 18.0±11.2 kg.ResultsIn all patients, PDA was ligated before the repair of intracardiac abnormities. No patient died in hospital. All patients were followed up, with a mean follow-up time of 18.0±8.0 months. No other complications such as residual shunts, arrhythmias, hemorrhaging or wound infection occurred after operations or during the follow-up period.ConclusionRVIAT is an emerging technique used for the surgical repair of PDA combined with intracardiac defects. It yields satisfying cosmetic results, without increasing postoperative complications or mortality.
Objective To explore the indication, advantage and disadvantage of modified or classical technique of intraoral sagittal split ramus osteotomy (SSRO) for correction of mandibular prognathism. Methods From January 1997 to January 2005, 95 patients suffering from mandibular prognathism or accompanied by other deformities were treated with modified or classical technique of intraoral SSRO. Of 95 cases, there were 34 males and 61 females, aging 15 to 44 years, including 53 cases of single mandibular prognathism, 28 cases accompanied with mandibular deviation, 11 cases accompanied with maxillaryretrognathism, 2 cases accompanied with glossacele and 1 case accompanied with malar protrution. X-ray cephalometry showed: sella-nasion-A point(SNA) 80-83°, sella-nasion-B point(SNB) 80-84°, A point-nasion-B point(ANB)-3-1°.Fortythree cases were corrected by modified SSRO and 52 cases by classical SSRO. Results The face appearance and dental articulation of all the patients were improved greatly. In patients by classical SSRO, disorder of local sensibility occurred in 9 cases, mandibular fracture during the cleavage ofthe ascending ramus in 1 case, significant bleeding in 1 case, postoperative infection in 1 case and postoperative relapse in 3 cases. In patients by modifiedSSRO, disorder of local sensibility occurred in 2 cases and postoperative relapse in 1 case; no mandibular fracture, significant bleeding, postoperative infection and other complications occurred. With a follow-up of 3 months to 7 years, X-ray cephalometry showed SNA 81-83°, SNB 78-81°and ANB 1-4°. 〖WTHZ〗Conclusion Modified SSRO is an ideal method of correcting mandibular prognathism, especially severer mandibularprognathism accompanied by mandible deviation deformity.
Objective To explore the clinical effect of combining medial and lateral canthoplasty with blepharoptosis correction at onestage for congenital blepharophimosis syndrome. Methods From January 2002 to May 2006, 26 patients(52 sides) with congenital blepharophimosis syndrome were treated. There were 16 males and 10 females, aging from 3 to 35 years (mean 8.5 years). They were all bilateral blepharoptosis significantly. The palpebral muscle force was 03 mm; the transverse dimension and vertical dimension of the palpebral fissue were 13-22 mm and 2-4 mm; the intercanthal distance was 33-44 mm; the levator function was 1-3 mm. Results Twenty-six patients underwent medial canthoplasty and blepharoptosis correction, of them, 12 patients were also given lateral canthoplasty at one-stage. The postoperative transverse dimension and vertical dimension of the palpebral fissue were 6-8 mm and 24-32 mm, respectively. The intercanthal distance was 29-34 mm. The levator function was 46 mm. The supratarsal fold in the upper lid was natural. With a follow up of 3 months to 4 years，all patients were satisfied with their results. Conclusion One-stage surgical treatment of combining medial and lateral canthoplasty with blepharoptosis correction can achieve good result for blepharophimosis syndrome with a shortened treatment time.
ObjectivesTo systematically review the effectiveness of one-phase treatment and two-phase treatment on the incidence of incisors trauma in patients with deep overjet, and to provide scientific basis for the selection of clinical treatment plans.MethodsPubMed, The Cochrane Library, Web of Science, CBM, CNKI, VIP and WanFang Data databases were searched to collect randomized controlled trials (RCTs) on the clinical effectiveness of one-phase treatment and two-phase treatment on the incidence of incisors trauma from inception to December 20th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by using RevMan 5.3 software.ResultsA total of 4 studies were included involving 613 patients. The results of meta-analyses showed that, there was no significant difference in the final overjet after one-phase treatment and two-phase treatment (functional appliance and headgear) (MD=–0.23, 95%CI –0.57 to 0.11, P=0.19). However, the new incidence of incisor trauma was significantly less for two-phase treatment group (functional appliance and headgear) (RR=0.69, 95%CI 0.48 to 0.99, P=0.05).ConclusionsPatients underwent two-phase treatment have lower incidence of dental trauma than one-phase treatment. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion
Objective To apply rapid prototyping (RP) technology on pre-fabricating nasoalveolar molding (NAM) appliances, and compare clinical outcomes and complications with traditional NAM appliances. Methods Between June 2014 and September 2016, 39 children with unilateral cleft lip and palate were included in study. Seventeen children (test group) had received novel NAM protocol by pre-fabricating NAM appliances using RP technology, and the other 22 children (control group) had received traditional NAM protocol. There was no significant difference in gender, age, the side of cleft lip and palate, and the width of the alveolar cleft gap before treatment between 2 groups (P>0.05). The change of width of the alveolar cleft gap, number of clinic visit, treatment time, and complications were compared between 2 groups. Results The number of clinic visit was less in test group than in control group (P<0.05). There was no significant difference in treatment time between 2 groups (P>0.05). During treatment, there was 16 children (72.2%) of skin irritation, 3 (13.6%) of mucosal ulceration, 1 (4.5%) of intraoral bleeding, 1 (4.5%) of alveolar arch T-shap asymmetry in control group. And there were 11 children (64.7%) of skin irritation, 3 (17.6%) of mucosal ulceration in test group. There was no significant difference in the incidence of complications between 2 groups (P>0.05). After treatment, the anterior alveolar cleft width, horizontal cleft width, sagittal cleft width, antero-medial alveolar ridges angle of the healthy side, angle between anterior alveolar and posterior alveolar baseline of the healthy side, perpendicular distance from buccal frenum point to sagittal line were significantly reduced when compared with the values before treatment (P<0.05). The angle between the anterior segments of two sides, angle between buccal frenum point and posterior baseline were significant increased when compared with the values before treatment (P<0.05). There was no significant difference in the differences between pre- and post-treatment of above indexes between 2 groups (P>0.05). There also was no significant difference in posterior alveolar width, the width between the middle parts of alveolar, vertical cleft width, antero-medial alveolar ridges angle of the affected side, and angle between anterior alveolar and posterior alveolar baseline of the affected side between pre- and post-treatment in each group (P>0.05). Conclusion Clinical outcome of novel approach was equivalent to traditional protocol; however, the number of clinic visit decreased. With improving of RP technology, it would provide a more consistency and convenient way for sequential treatment with cleft lip and palate.
Abstract: Objective To evaluate the results of surgical treatment of tetralogy of Fallot in adults． Methods From July 2002 to August 2009，75 adult patients with tetralogy of Fallot received surgical treatment in Xijing Hospital, ForthMilitary Medical University．There were 35 males and 40 females, with age at l7 to 37 years (23.30±3.50 years), and eoperativehemoglobin at 143 to 231 g/L(172.00±31.00 g/L)．All these patients were diagnosed by.echocardiograph before operation. All the patients were received tetralogy of Fallot of corrective operation in the hypothermia cardiopulmonary bypass. A total of 46 patients had a transannular right ventricular outflow tract patch，and 29 patients had a non ansannular patch． Results Operation time was 157 to 276 min(221.32±41.34 min), cardiopulmonary bypass time was 68 to 163 min(91.71±28.35 min) and aorta intercepted time was 37 to 96 min（55.47±23.61 min）. There were 6 operative deaths with an operative mortality at 8.00％. The causes of death were low output syndrome(n=3)，acute renal failure(n=2)， and multiple organ failure(n=1)．Nine patients needed reoperation for postoperative bleeding(12.00％)．We followed up 69 patients from 3 to 56 months (26.31±7.40 months). There were 2 patients with trivial residual shunt. The cardiac function status were New York Heart Association(NYHA) Ⅰ to Ⅱ in the 69 patients．No late death occured． Conclusion The effectiveness of surgical treatment for adults with tetralogy of Fallot is satisfactory．
ObjectiveTo discuss whether there are some psychological changes in adult women patients when they first wear fixed orthodontic appliances. MethodsEighty adult women patients aged between 18 and 50 years old averaging 35, receiving fixed orthodontic treatment between January 2011 and August 2012 were selected as our study subjects. They completed a questionnaire regarding anxiety and depression at the first day when they came to the hospital and 7 days, one month, and three months after fixed appliance placement respectively. The scales of anxiety and depression of subjects were assessed according to the symptom checklist-90 (SCL-90). ResultsCompared with the norms, the SCL-90 scores of anxiety, depression and interpersonal relationship sensitivity were higher in these patients. The symptoms were more severe a week later, and were even more severe one month after the appliance placement. Three months later, the scores of all factors began to fall, but were still higher than those before the treatment. ConclusionThere is a certain extent of negative psychological influence on adult women patients during fixed orthodontic treatment. At the first week after the placement of fixed appliance, adult women patients may suffer from anxiety and depression.