ObjectiveTo review the research progress of digital occlusion setup in orthognathic surgery. Methods The literature related to digital occlusion setup in orthognathic surgery in recent years was consulted, and the imaging basis, methods, clinical applications as well as existing problems were reviewed. Results Digital occlusion setup in orthognathic surgery includes manual, semi-automatics, and fully automatic methods. The manual method mainly relies on visual cues for operation, which is difficult to ensure the best occlusion set up, though relatively flexible. The semi-automatic method utilizes the computer software for partial occlusion set up and adjustment, but the occlusion result is still largely depended by manual operation. The fully automatic method completely depends on the operation of computer software, and targeted algorithms for different occlusion reconstruction situations are needed. Conclusion The preliminary research results have confirmed the accuracy and reliability of digital occlusion setup in orthognathic surgery, but there are still some limitations. Further research is needed in terms of postoperative outcomes, doctor and patient acceptance, planning time and cost-effectiveness.
OBJECTIVE: To investigate the effect of soft tissue repairing at different times on the union of type III b tibial fracture. METHODS: From January 1987 to January 1999, seventy-six type III b tibial fractures were divided into 3 groups: early group(0 to 7 days), subacute group(8 to 30 days), late group(more than 30 days) according to the time of soft tissue repairing. The morbidity rates of complications such as infection, nonunion as well as the time to union were compared respectively. RESULTS: Followed up for 10 to 36 months (averaged 24 months), the infection and nonunion rates of early group were lower than that of subacute and late groups(P lt; 0.01), the average time of fracture union of early group was less than that of subacute and late groups. CONCLUSION: Early soft tissue repairing can decrease the complications and the time to union of Type III b tibial fracture obviously. The time of "early" should be limited in one week and as soon as possible.
Objective To analyze the clinical and pathological features of lung cancer with metastasis, explore the regularity and characteristics of the location of metastasis, and provide reference for future clinical treatment. Methods A total of 658 patients with lung cancer treated in West China Hospital of Sichuan University from January 2008 to December 2014 were enrolled in this study. The effect of different clinical and pathological characteristics on different locations of metastasis was analyzed by χ2 test and logistic regression. Results Adenocarcinoma was the main pathological type (342 cases, 52.0%), and bone (150 cases, 22.8%) and pleura (118 cases, 18.0%) were the most common distant metastasis. Compared with patients with no corresponding metastasis, patients with age <60 years took bigger proportions in patients with bone, brain and mediastina metastasis ( P<0.05). Furthermore, logistic regression analysis showed that the younger patients were more likely to have brain metastasis (P=0.024). Besides, the elder patients were more common in those with liver metastasis (P<0.001). The proportion of males was higher in the patients with lymph node metastasis than those without lymph node metastasis (P=0.010); however, the proportion of females was higher in patients with bone or pleural metastasis than those without bone or pleural metastasis (P<0.05). There was no significant difference in gender among patients with brain, lung, liver, adrenal and mediastinal metastases (P>0.05). Conclusions Bone and pleura are the most common sites of metastasis of lung cancer. The age structure of brain metastasis tends to be younger.
ObjectiveTo identify differences in blood routine indicators between lung cancer patients and healthy controls, and between different subgroups of lung cancer patients, so as to improve the early detection of lung cancer prognosis, and provide a basis for risk stratification and prognostic judgment for patients with lung cancer.MethodsThis study enrolled 1 227 patients pathologically diagnosed with lung cancer from December 2008 to December 2013 and 2 454 healthy controls 1∶2 matched by sex and age. The blood routine data of lung cancer patients were collected when they were first diagnosed with lung cancer. Gender and age stratified analysis of blood routine indicators between lung cancer patients and controls were conducted. Comparisons of blood routine indicators among lung cancer patients with different pathological types, stages, and prognosis were performed, followed by Cox regression survival analysis. Normally distributed quantitative variables were presented as mean ± standard deviation and non-normally distributed quantitative variables as medium (lower quartile, upper quartile).ResultsCompared to healthy controls, the counts of platelet [(206.84±80.47) vs. (175.27±55.74)×109/L], white blood cells [(7.04±2.29) vs. (6.08±1.40)×109/L], neutrophil [(4.90±2.08) vs. (3.61±1.07)×109/L], monocyte [0.42 (0.30, 0.54) vs. 0.33 (0.26, 0.42)×109/L], and eosinophil [0.14 (0.07, 0.24) vs. 0.12 (0.07, 0.19)×109/L], as the well as neutrophil-lymphocytes ratio (3.91±2.82 vs. 2.03±0.89) and platelet-lymphocyte ratio (160.35±96.06 vs. 96.93±38.02) in lung cancer patients increased significantly, while the counts of red blood cells [(4.41±0.58) vs. (4.85±0.51)×1012/L] and lymphocyte [(1.49±0.60) vs. (1.93±0.59)×109/L] in lung cancer patients decreased, and the differences were statistically significant (P<0.05). The counts of platelet, red blood cells, white blood cells, neutrophil, and monocyte differed among patients with different pathological types, tumor stages, and prognosis (P<0.05). Neutrophil-lymphocytes ratio and platelet-lymphocyte ratio were higher in squamous cell carcinoma patients than those in other pathological patients, higher in advanced lung cancer patients than those in early stage patients, and higher in dead lung cancer patients than those in survival patients (P<0.05). Neutrophil-lymphocyte ratio was an independent factor affecting the prognosis of lung cancer [hazard ratio=1.077, 95% confidence interval (1.051, 1.103), P<0.001].ConclusionsThe inflammatory index of blood routine indicators are higher in lung cancer patients than those in healthy controls, which indicates that lung cancer is closely related to chronic inflammation. There are significant differences in blood routine inflammation index among lung cancer patients with different pathological types, stages, and prognosis, which reflects the heterogeneity and complexity of lung cancer. Neutrophil-lymphocytes ratio inverse correlates with the prognosis of lung cancer.
ObjectiveTo explore the prognostic value of fasting blood glucose concentration in patients with newly diagnosed lung cancer.MethodsThe clinical data of 956 patients with lung cancer who were first diagnosed at West China Hospital of Sichuan University between January 2008 and December 2011 were retrospectively analyzed. The patients were followed up for more than 5 years. Using the fasting blood glucose concentration of 6.1 mmol/L as the cut-off value, the patients were divided into the hyperglycemia group and the control group. Kaplan-Meier method was used for survival analysis, and log-rank test was used to analyze the survival of different groups. Univariate and multivariate Cox proportional hazard models were used to evaluate the prognostic variables.ResultsThere were 166 patients in the hyperglycemia group with a 5-year overall survival rate of 23.5%, and 790 patients in the control group with a 5-year survival rate of 30.8%, and the difference between the two groups was statistically significant (P=0.008). Univariate Cox proportional hazard analysis found that blood glucose concentration, gender, age, smoking history, staging, and whether surgery were factors that affected the 5-year survival rate of patients (P<0.05); multivariate Cox proportional hazard analysis showed that blood glucose concentration [hazard ratio (HR)=1.235, 95% confidence interval (CI) (1.013, 1.504), P=0.036], age [HR=1.305, 95%CI (1.110, 1.534), P=0.001], smoking history [HR=1.210, 95%CI (1.033, 1.418), P=0.018], staging [HR=1.546, 95%CI (1.172, 2.040), P=0.002], and whether surgical treatment [HR=0.330, 95%CI (0.257, 0.424), P<0.001] were independent factors which influenced 5-year survival rate. Blood glucose concentration, age, smoking history, and staging were independent risk factors.ConclusionFasting blood glucose concentration is able to be a prognostic factor for patients with newly diagnosed lung cancer.
Objective To review the research progress of the osteogenic effect of strontium (Sr) and its application in the orthopaedics. Methods The recent literature concerning the osteogenic effect of Sr and its application in orthopaedics at home and abroad was extensively reviewed, and the research and development were summarized. Results Both in vivo and in vitro studies showed that Sr could enhance bone formation and inhibit bone resorption. Clinically, Sr was applied for treatment of osteoporosis, composite biomaterials in tissue engineering, and treatment of bone tumors and bone metastases. Conclusion Sr is one important combined element of alternative materials in bone tissue engineering, and can strengthen the mechanical and biological properties of the bone replacement material, so it has some development potential in bone tissue engineering.
ObjectiveTo explore the prognostic value of modified Glasgow Prognostic Score (mGPS) in lung cancer patients.MethodsThe clinical data and follow-up information of patients with lung cancer diagnosed for the first time in West China Hospital of Sichuan University from August 2008 to May 2013 were retrospectively analyzed. Overall survival (OS) of patients with different mGPS were compared by Kaplan-Meier test and log-rank test. Univariate and multivariate Cox proportional hazard analysis were performed, and hazard ratio (HR) and 95% confidence interval (CI) were counted to evaluate the predictive value of different prognostic factors in patients with lung cancer.ResultsA total of 289 patients were included. According to the mGPS score, 127 patients had 0 point, 90 patients had 1 point, and 72 patients had 2 points. The OS of lung cancer patients with mGPS=0 was better than that of patients with mGPS=1 and mGPS=2 (P<0.001). Cox proportional hazards of univariate analysis revealed that age< 65 (P=0.022), stage for Ⅰand Ⅱ (P<0.001), surgery (P<0.001), chemotherapy (P=0.018), and mGPS=0 (1 vs. 0, P=0.008; 2 vs. 0, P<0.001) were the protective factors for lung cancer patients (P<0.05). Multiple-factor analysis showed that age [HR=0.680, 95%CI (0.508, 0.911), P=0.010], stage [HR=0.580, 95%CI (0.359, 0.939), P=0.027], operation [HR=0.254, 95%CI (0.140, 0.459), P<0.001], chemotherapy [HR=0.624, 95%CI (0.435, 0.893), P=0.010], mGPS (1 vs. 0) [HR=1.548, 95%CI (1.101, 2.176), P=0.012] and mGPS (2 vs. 0) [HR=1.425, 95%CI (1.003, 2.024), P=0.048] were independent predictors of OS in patients with lung cancer.ConclusionmGPS could be considered as an independent prognostic factor in lung cancer.
ObjectiveTo explore the clinical value of low-dose contrast agnet in CT angiography (CTA) for head and neck by SOMATOM Definition Flash CT.MethodsSixty consecutive patients with head and neck vessel diseases examined by CTA in the head and neck were chosen from West China Hospital of Sichuan University from March to July 2015, and then were randomly divided into two groups (the experimental group: n=30, 30 mL contrast medium; the control group: n=30, 50 mL contrast medium). Imaging post processing techniques included curved plannar reconstruction, volume rendering, and maximal intensity projection. CT values of the different level of carotid arteries (aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery) were measured. The artifact of the remaining contract in the jugular vein and overall quality of the image were observed by two senior doctors using double blind method.ResultsAll the patients in the two groups completed CTA for head and neck successfully. The image qualities of the two groups satisfid clinical diagnostic requirements, and there was no difference in the image qualities between the two groups (P>0.05). The evaluation of venous pollution in the experimental group was lighter than that in the control group (P<0.05). The CT values of aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery in the experimental group [(341.3±89.5), (391.0±103.7), (305.0±62.0) HU] were slightly lower than those in the control group [(437.3±83.7), (532.5±113.3), (396.6±93.1) HU], which were statistically significant (P<0.05).ConclusionLow-dose contrast in CTA for head and neck by SOMATOM Definition Flash CT can satisfy the clinical diagnostic requirements, and reduce the dose of contrast agent and venous pollution, with a good clinical value.
ObjectiveTo investigate the expression change characteristic of stemness-related markers for recurrent hepatocellular carcinoma (HCC), and to discuss the relationship between stemness-related markers and clinicopathologic characteristics of HCC.MethodsWe collected 25 recurrent HCC patients who also had the first liver resection for HCC in Sichuan Cancer Hospital from Jan. 2010 to Oct. 2018. Immunohistochemistry was used to compare expressions of CD133, CD90, CD117, and epithelial cell adhesion molecule (EpCAM) in HCC tissues. Fluorescence in situ hybridization was used to detect telomere length.ResultsThe primary HCC had higher platelet count, larger tumor, less microvascular invasion (MVI), and less multiple HCC than the recurrent HCC (P<0.05), but the expressions of CD90, CD133, CD117, and EpCAM were not significantly differed after recurrence (P>0.05). The expressions of CD90, CD133, CD117, and EpCAM were not associated with tumor size, tumor number, Barcelona Clinic Liver Cancer Staging (BCLC staging), satellite nodules, and differentiation (P>0.05). The MVI-positive group had a significantly higher expression level of EpCAM (P=0.016) and longer telomere length (P=0.001). The telomere length was longer for tumors diameter less than 5 cm (P=0.038) and poor differentiation (P=0.046). Correlation analysis found that there was no relationship between telomere length and expression levels of EpCAM (r=–0.092, P=0.513), CD90 (r=–0.235, P=0.100), CD133 (r=0.024, P=0.867), and CD117 (r=–0.277, P=0.052), but an apparent positive correlation between expression levels of EpCAM and CD133 was found (r=0.358, P=0.011). Survival analysis found that poor differentiation (P=0.003) and BCLC B–C staging (P=0.040) were the risk factors of disease-free survival for patients after first HCC resection, and BCLC B–C staging (P=0.017) and tumor diameter more than 5 cm (P=0.035) were the risk factors for recurrent HCC.ConclusionsRecurrent HCC had similar stemness-related markers expression and longer telomere length. Expression level of EpCAM and telomere length were associated with MVI.
Objective To retrospectively analyze the morbidity, mortality, epidemiologic trends and distribution characteristic of top-three malignant tumors in Chengdu from 1990 to 2010, and to be aware of the incidence risk factors, and types and syn-position of main tumors, so as to provide evidence for the policy-making of tumor prevention and control. Methods ICD-10 coding method was used to categorize diseases and analyze the morbidity and mortality of malignant tumors seen in different ages, genders, areas and types, based on the surveillance data in Chengdu collected since 1990. Results The morbidity reports of top-three malignant tumors in Chengdu from 1999 to 2010 were lung cancer, liver cancer and colorectal cancer, the same as the mortality reports from 1999 to 2005, But the mortality of gastric cancer exceeded that of colorectal cancer and ranked as the third from 2005 to 2010. The mortality of top-three malignant tumors in male patients was higher than those in female patients. No difference was observed between urban and rural areas. The mortality of main malignant tumors rose along with the age growth. Conclusion Lung cancer, liver cancer and gastric cancer have become the main malignant tumors threatening Chengdu civilians, and their morbidity and mortality are rising yearly, which suggests that the prevention and control measures such as early diagnosis and treatment should be implemented aiming directly at those main tumors.