Publications by authors named "Wen-Bo Zhang"

89 Publications

Development of a nomogram for predicting clinical outcome in patients with angiogram-negative subarachnoid hemorrhage.

CNS Neurosci Ther 2021 Jul 28. Epub 2021 Jul 28.

Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, China.

To the best of our knowledge, this is the largest clinical retrospective study in AN-SAH patients, and is the first time to establish accurate predictive models paired with bleeding pattern.

Background: Angiogram-negative subarachnoid hemorrhage (AN-SAH) has a definite incidence of delayed cerebral ischemia (DCI) and poor clinical outcomes. The purpose is to screen independent factors and establish a nomogram to guide the clinical therapy and assess post-discharge prognosis.

Methods: We identified 273 consecutive patients referred to our institute from 2013 to 2018 for AN-SAH. A nomogram to predict poor outcomes was formulated based on the multivariable models of independent risk factors. The accuracy and discrimination of nomograms were determined in training and internal validation cohorts.

Results: The overall poor outcome rates of AN-SAH were 14.3% and 8.7% at 3 months and 12 months, respectively. In addition, perimesencephalic AN-SAH (PAN-SAH) presented with a more unfavorable prognosis compared with non-perimesencephalic AN-SAH (NPAN-SAH). The clinical prognosis was associated with the World Federation of Neurosurgical Societies scale (WFNS) (odds ratio, 3.82 [95% CI, 1.15-12.67] for 3-month outcome; and odds ratio, 31.69 [95% CI, 3.65-275.43] for 12-month outcome), Subarachnoid hemorrhage Early Brain Edema Score (SEBES) (odds ratio, 10.39 [95% CI, 1.98-54.64] for 3-month outcome; odds ratio, 10.01 [95% CI, 1.87-53.73] for 12-month outcome), and symptomatic vasospasm (odds ratio, 3.16 [95% CI, 1.03-9.70] for 3-month outcome; odds ratio, 5.15 [95% CI, 1.34-19.85] for 12-month outcome). The nomogram was constructed based on the above features, which represented great predictive value in clinical outcomes.

Conclusions: Symptomatic vasospasm, high WFNS, cerebral edema, and NPAN-SAH after hemorrhage were associated with poor outcome of AN-SAH. The nomogram with WFNS (3-5), SEBES (3-4), vasospasm, and NPAN-SAH represented a practical approach to provide individualized risk assessment for AN-SAH patients.
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http://dx.doi.org/10.1111/cns.13712DOI Listing
July 2021

An MRI Image Analysis of Primary Cardiac Neoplasms.

Int J Gen Med 2021 28;14:2943-2951. Epub 2021 Jun 28.

Department of Magnetic Resonance Imaging, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People's Republic of China.

Objective: This study aimed to examine the magnetic resonance imaging (MRI) characteristics of primary cardiac neoplastic lesions.

Methods: A retrospective investigation was conducted on 24 cases of primary cardiac neoplastic lesions as confirmed by surgery and pathology results. All the cases in this study received MRI multi-sequence and multi-dimension scanning, including the cardiac long-axis and short-axis cine sequences, parameter sequences of the cardiac long axis and short axis (T1WI, T2WI), first-pass perfusion sequence, and delayed enhancement sequence of the cardiac long axis and short axis. The age and gender of the patients and the location, size, signal characteristics, and relationship with the neighboring tissues of all the lesions were examined.

Results: Twenty-four cases of primary neoplastic lesions were examined in this study, the onset age was 11-72 years old, the median age was 53 years old, and the mean age was 46 years old. Among these cases, there were 8 cases including males and 16 cases including females, 19 cases were benign lesions; including 11 cases of myxoma, 4 cases of hemangioma, 1 case of paraganglioma, 1 case of PEcoma, 1 case of hamartoma, and 1 case of lipoma. The malignant lesions included 3 sarcomas and 2 lymphomas in 5 patients.

Conclusion: MRI imaging provides a great value in the preoperative classification of primary cardiac neoplastic lesions.
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http://dx.doi.org/10.2147/IJGM.S296381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8254406PMC
June 2021

Long-term Effect of Individualized Titanium Mesh in Orbital Floor Reconstruction After Maxillectomy.

Laryngoscope 2021 Oct 13;131(10):2231-2237. Epub 2021 Apr 13.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

Objective: The aim of this study was to determine the clinical outcomes and long-term stability of individualized titanium mesh combined with free flap for orbital floor reconstruction after maxillectomy and to identify the risk factors for titanium mesh exposure.

Material And Methods: The data of 66 patients who underwent maxillectomy and orbital floor defect reconstruction by individualized titanium mesh in Peking University School and Hospital of Stomatology between 2011 and 2019 were retrospectively reviewed. Postoperative ophthalmic function and success of aesthetic restoration were assessed. Titanium mesh exposure was recorded and the risk factors were identified.

Results: Mean follow-up was for 24.8 months (range, 6-92 months). Ophthalmic function was successfully restored in 63/66 patients. Aesthetic restoration was not considered satisfactory by 10 patients. Titanium mesh exposure occurred in six patients (exposure rate, 9.1%). Preoperative radiotherapy was identified as an independent risk factor for mesh exposure (OR = 28.8, P = 0.006). Previous surgery, postoperative radiotherapy, pathological type of the primary lesion, the type of tissue flap applied, and the use of intraoperative navigation were not significant risk factors. Six patients with titanium mesh exposure underwent second surgery, but mesh exposure recurred in two patients due to insufficient soft tissue coverage.

Conclusion: Individualized titanium mesh with free flap can effectively restore maxilla-orbital defects. Preoperative radiotherapy is an independent predictor of postoperative titanium mesh exposure. Adequate soft tissue coverage of the mesh may reduce the risk of mesh exposure.

Level Of Evidence: 4 (case-control study) Laryngoscope, 131:2231-2237, 2021.
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http://dx.doi.org/10.1002/lary.29569DOI Listing
October 2021

Lactate-induced M2 polarization of tumor-associated macrophages promotes the invasion of pituitary adenoma by secreting CCL17.

Theranostics 2021 6;11(8):3839-3852. Epub 2021 Feb 6.

Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Lactate greatly contributes to the regulation of intracellular communication within the tumor microenvironment (TME). However, the role of lactate in pituitary adenoma (PA) invasion is unclear. In this study, we aimed to clarify the effects of lactate on the TME and the effects of TME on PA invasion. To explore the correlation between TME acidosis and tumor invasion, LDHA and LAMP2 expression levels were quantified in invasive (n = 32) and noninvasive (n = 32) PA samples. The correlation between immune cell infiltration and tumor invasion was evaluated in 64 PAs. Critical chemokine and key signaling pathway components were detected by qPCR, Western blotting, siRNA knockdown, and specific inhibitors. The functional consequences of CCR4 signaling inhibition were evaluated and . Lactate was positively associated with PA invasion. Of the 64 PA tissues, invasive PAs were related to high infiltration of M2-like tumor-associated macrophages (TAMs) (P < 0.05). Moreover, lactate secreted from PA cells facilitated M2 polarization the mTORC2 and ERK signaling pathways, while activated TAMs secreted CCL17 to promote PA invasion the CCL17/CCR4/mTORC1 axis. According to univariate analysis of clinical data, high CCL17 expression was associated with larger tumor size (P = 0.0438), greater invasion (P = 0.0334), and higher susceptibility to postoperative recurrence (P = 0.0195) in human PAs. This study illustrates the dynamics between PA cells and immune TME in promoting PA invasion M2 polarization. CCL17 levels in the TME are related to the PA invasiveness and clinical prognosis, and the CCL17/CCR4/mTOCR1 axis may serve as potential therapeutic targets for Pas.
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http://dx.doi.org/10.7150/thno.53749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914368PMC
July 2021

Improved procedure for Brown's Class III maxillary reconstruction with composite deep circumflex iliac artery flap using computer-assisted technique.

Comput Assist Surg (Abingdon) 2021 12;26(1):9-14

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

Reconstruction of Brown's Class III maxillary defect can be challenging due to the complex geometry of maxilla. We aimed to introduce an improved method for maxillary reconstruction with a composite deep circumflex iliac artery (DCIA) flap aided by virtual surgical planning and intraoperative navigation. A 27-year-old woman diagnosed with left maxillary fibromyxoma was admitted to our institution in December 2018. Pre-operative facial and iliac computed tomography data were obtained for virtual surgical planning. Personalized cutting template, tooth-supported surgical guide, and rapid prototype model with reconstructed orbital floor were printed for pre-operative preparation. Surgery was completely guided by the intraoperative navigation system. The root mean square estimate of the reconstructed area was 3.68 mm. The average errors measured on the lateral and medial DCIA segments were 0.61 and 0.85 mm, respectively. Application of virtual surgical planning and intraoperative navigation could potentially enhance the reconstruction outcomes.
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http://dx.doi.org/10.1080/24699322.2021.1876168DOI Listing
December 2021

Efficacy of computed tomography features in the differentiation of basal cell adenoma and Warthin tumor in the parotid gland.

Oral Surg Oral Med Oral Pathol Oral Radiol 2021 Jan 2:4540. Epub 2021 Jan 2.

Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address:

Objective: The aim of this study was to identify computed tomography (CT) features that differentiate basal cell adenoma (BCA) from Warthin tumor (WT).

Materials And Methods: Histopathologically confirmed parotid gland tumors (57 BCAs and 83 WTs) were retrospectively reviewed. CT images were evaluated to determine location, distribution, cyst formation, size, the new vessel facing sign (VFS), and enhancement behavior including the CT attenuation of solid portions of the tumor (AST), the vessel near the tumor (AVT), and maxillary artery (AMA) on early stage 2-phase contrast CT. Tumor CT attenuation ratios (AST/AVT and AST/AMA) were calculated. Chi-square tests, independent t-tests, and receiver operating characteristic curve analysis were conducted.

Results: Male:female ratio, patient age, posteroinferior location, tumor size, and presence of VFS were significantly lower for BCA than WT. The average AST/AVT was significantly higher for BCA than WT. The threshold value for AST/AVT on early stage 2-phase contrast CT was 0.72 between BCA and WT, and sensitivity and specificity were 94.7% and 98.8%, respectively, as calculated by receiver operating characteristic analysis.

Conclusion: Gender ratio, age, location, size, presence of VFS, and AST/AVT value may help to differentiate BCA from WT in parotid glands on CT examination.
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http://dx.doi.org/10.1016/j.oooo.2020.12.022DOI Listing
January 2021

A survey on the application of oral propranolol and atenolol for the management of infantile hemangiomas in mainland China: Survey on propranolol atenolol hemangiomas.

Medicine (Baltimore) 2021 Jan;100(1):e24146

Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai.

Abstract: Since 2008, oral propranolol has evolved as the first-line therapy for infantile hemangiomas (IHs). Meanwhile, oral atenolol gradually shows comparative effectiveness versus oral propranolol with few side effects. Here, we conducted a mobile internal survey among a group of Chinese clinicians about how they choose the dosage, dose regimen, and dose escalation methods of propranolol and atenolol for the treatment of IH.A mobile-ready internal survey on the application of oral propranolol and oral atenolol for IH in mainland China was performed and distributed to 333 potential clinicians from different levels of healthcare institutions in mainland China. Eighty-one doctors responded to the survey. All the respondents had the experience of treating IH with oral propranolol and 32 had the experience with oral atenolol.Most of the doctors from tertiary hospitals chose 2 mg/kg/d twice daily, while most of those with the experience of propranolol from private hospitals chose 1 mg/kg/d once daily. More doctors from tertiary hospitals had the experience of atenolol than those from private hospitals.Oral atenolol has become another medication intervention option for IH in mainland China. This survey is helpful to standardize and develop a guideline of oral atenolol therapy for IH.
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http://dx.doi.org/10.1097/MD.0000000000024146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793351PMC
January 2021

Cardiac parameters affect prognosis in patients with non-large atherosclerotic infarction.

Mol Med 2021 01 6;27(1). Epub 2021 Jan 6.

Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Background: Although large artery atherosclerosis (LAA) is the most common type of cerebral infarction, non-LAA is not uncommon. The purpose of this paper is to investigate the prognosis of patients with non-LAA and to establish a corresponding nomogram.

Patients And Methods: Between June 2016 and June 2017, we had 1101 admissions for acute ischemic stroke (AIS). Of these, 848 were LAA and 253 were non-LAA. Patients were followed up every 3 months with a minimum of 1 year of follow-up. After excluding patients who were lost follow-up and patients who did not meet the inclusion criteria, a total of 152 non-LAA patients were included in this cohort study. After single-factor analysis and multifactor logistic regression analysis, the risk factors associated with prognosis were derived and different nomograms were developed based on these risk factors. After comparison, the best model is derived.

Results: Logistics regression found that the patient's National Institutes of Health Stroke Scale (NIHSS) score, ejection fraction (EF), creatine kinase-MB (CK-MB), age, neutrophil-to-lymphocyte ratio (NLR), aspartate aminotransferase (AST), and serum albumin were independently related to the patient's prognosis. We thus developed three models: model 1: single NIHSS score, AUC = 0.8534; model 2, NIHSS + cardiac parameters (CK-MB, EF), AUC = 0.9325; model 3, NIHSS + CK-MB + EF + age + AST + NLR + albumin, AUC = 0.9598. We compare the three models: model 1 vs model 2, z = - 2.85, p = 0.004; model 2 vs model 3, z = - 1.58, p = 0.122. Therefore, model 2 is considered to be the accurate and convenient model.

Conclusions: Predicting the prognosis of patients with non-LAA is important, and our nomogram, built on the NIHSS and cardiac parameters, can predict the prognosis accurately and provide a powerful reference for clinical decision making.
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http://dx.doi.org/10.1186/s10020-020-00260-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788897PMC
January 2021

Three-Dimensional Accuracy of Bone Contouring Surgery for Zygomaticomaxillary Fibrous Dysplasia Using Virtual Planning and Surgical Navigation.

J Oral Maxillofac Surg 2020 12 31;78(12):2328-2338. Epub 2020 Jul 31.

Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address:

Purpose: Fibrous dysplasia (FD) is a benign condition in which normal cancellous bone is replaced by immature woven bone and fibrous tissue. The present study aimed to estimate and compare the 3-dimensional (3D) accuracy of bone contouring surgery for zygomaticomaxillary FD performed using virtual planning and surgical navigation versus surgeon's intraoperative assessment.

Patients And Methods: This is a retrospective cross-sectional study. Patients with zygomaticomaxillary FD who underwent bone contouring surgery between 2012 and 2019 were reviewed. They were divided into 2 groups: group A underwent bone contouring surgery using virtual planning and surgical navigation, and group B underwent bone contouring surgery by surgeon's intraoperative assessment. The predictor variable was surgical technique. The other variables were gender, age, and operative region. The primary outcome variable was 3D accuracy, which was indicated by root mean square, calculated as a measure of the deviation of the postoperative computed tomography from the preoperative virtual plan. The other outcome variables were patient satisfaction with the outcome by self-evaluation score and operative times. Correlation analysis between the predictor variables and outcome variables was performed.

Results: The sample comprised 24 patients (17 males and 7 females, mean age, 25.7 ± 10.45 years), 13 patients in group A and 11 patients in group B. The mean root mean square was significantly lower in group A than in group B (P = .007). Patient satisfaction with facial symmetry was significantly better in group A (P = .015). Mean operative time was comparable between the 2 groups (P = .918). Surgical technique (P = .011) and operative region (P = .01) were significant influence factors in 3D accuracy of surgery.

Conclusions: Virtual planning and surgical navigation can significantly improve the 3D accuracy and patient satisfaction of bone contouring surgery for zygomaticomaxillary FD, without prolonging operative time.
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http://dx.doi.org/10.1016/j.joms.2020.07.208DOI Listing
December 2020

Factors Affecting Volume Change of Anterolateral Thigh Flap in Head and Neck Defect Reconstruction.

J Oral Maxillofac Surg 2020 11 15;78(11):2090-2098. Epub 2020 Jun 15.

Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address:

Purpose: The anterolateral thigh flap (ALTF) volume will decrease over time after surgery. We measured and identified the risk factors for postoperative volume changes in the ALTF.

Materials And Methods: We designed and performed a retrospective cohort study of patients who had undergone reconstruction of oral and maxillofacial defects using ALTFs at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from June 2012 to December 2018. We measured the volume of the ALTFs at 1, 3, 6, 12, and 24 months postoperatively; the flap volume at 1 month postoperatively was taken as the baseline. The primary outcome variables were the residual ALTF rates at 3, 6, 12, and 24 months postoperatively, defined as the ratio between the present volume at each month and at baseline. The primary predictor variables were the clinical variables that might be associated with ALTF volume loss. Descriptive and bivariate statistics were computed, and the P value for statistical significance was set at ≤ .05.

Results: The sample included 70 subjects with a mean age of 53.8 years (46 men and 24 women). The postoperative residual rates at 3, 6, 12, and 24 months were 72.3, 69.0, 67.9, and 68.7%, respectively, of the baseline volume. The use of postoperative radiotherapy (P < .01) and low body mass index (BMI; P = .006) were significantly associated with postoperative ALTF volume loss.

Conclusions: The results of the present study suggest that ALTF volume shrinkage mainly occurs within 6 months postoperatively and that postoperative radiotherapy and a low BMI are risk factors for volume loss. Overcorrection should be performed to account for the shrinkage of ALTFs, and postoperative nutrition management is important to avoid ALTF volume loss.
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http://dx.doi.org/10.1016/j.joms.2020.06.017DOI Listing
November 2020

Accuracy of multimodal image fusion for oral and maxillofacial tumors: A revised evaluation method and its application.

J Craniomaxillofac Surg 2020 Aug 10;48(8):741-750. Epub 2020 Jun 10.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Beijing 100081, China. Electronic address:

Objective: To develop a revised evaluation method for accuracy of multimodal image fusion for oral and maxillofacial tumors and explore its application for comparing the accuracy of three commonly used fusion algorithms, automatic fusion, manual fusion, and registration point-based fusion.

Materials And Methods: Image sets of patients with oral and maxillofacial tumor were fused using the iPlan 3.0 navigation system. Fusion accuracy included two aspects: (1) overall fusion accuracy: represented by the mean value of the coordinate differences along the x-, y-, and z- axes (Δx, Δy, and Δz), mean deviation (MD), and root mean square (RMS) of six pairs of landmarks on the two image sets; (2) tumor volume fusion accuracy: represented by Fusion Index (FI), which was calculated based on the volume of tumor delineated on the two image sets.

Results: Eighteen pairs of image sets of 17 patients were enrolled in this study. The Δx and Δy values for the three algorithms were less than 1.5 mm. The Δz values for automatic fusion, manual fusion and registration point-based fusion was 1.049 mm, 1.864 mm and 1.254 mm. The MD for automatic fusion, manual fusion and registration point-based fusion was 1.978 mm, 2.788 mm and 1.926 mm. Significant differences existed in Δz for manual fusion and that for automatic fusion (P = 0.058), in MD for manual fusion and that for automatic fusion (P = 0.087), and in MD for manual fusion and that for registration point-based fusion (P = 0.069). The FI for automatic fusion, manual fusion, and registration point-based fusion was 0.594, 0.520, and 0.549; the inter-algorithm differences were not significant (P = 0.290).

Conclusion: The automatic fusion and the registration point-based fusion were more accurate than manual fusion, and therefore were recommended to be used in multimodal image fusion for oral and maxillofacial tumors.
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http://dx.doi.org/10.1016/j.jcms.2020.05.009DOI Listing
August 2020

Hypermethylated PAX1 and ZNF582 genes in the tissue sample are associated with aggressive progression of oral squamous cell carcinoma.

J Oral Pathol Med 2020 Sep 3;49(8):751-760. Epub 2020 Jun 3.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

Background: DNA methylation of paired box gene 1 (PAX1) and zinc finger 582 (ZNF582) is promising cancer biomarkers for oral squamous cell carcinoma detection. This study aims to investigate the correlation between PAX1 or ZNF582 methylation and the progression of oral squamous cell carcinoma (OSCC).

Materials And Methods: A total of 135 OSCC cases from Peking University School and Hospital of Stomatology were enrolled in this study. Tissue specimens were collected from the lesion site and corresponding adjacent normal site. The methylation level of these two genes was evaluated in primary and recurrent OSCC group.

Results: Hypermethylation of PAX1 or ZNF582 was observed in lesion sites among primary and recurrent OSCC cases. In the lesion site of primary cases, promoter methylation was observed in T3/T4 (PAX1: P = .02; ZNF582: P = .01), stage III/IV (PAX1: P = .03; ZNF582: P = .01), and bone invasion cases (PAX1: P = .02; ZNF582: P = .047). In the subgroup analysis, the correlation between hypermethylation and OSCC severity remains significant with exposure to smoking/alcohol consumption.

Conclusions: Hypermethylated PAX1 and ZNF582 can sufficiently act as biomarkers to reflect the severity or progression of OSCC.
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http://dx.doi.org/10.1111/jop.13035DOI Listing
September 2020

Expert Consensus on Navigation-guided Unilateral Orbital Fracture and Orbital Floor Reconstruction Techniques.

Chin J Dent Res 2020 ;23(1):51-55

Orbital fracture and orbital floor reconstruction surgery is characterised by limited surgical exposure and high risks. Before the advent of digital technology, the design and implementation of the surgical scheme for orbital floor reconstruction surgery mainly depended on the intuitive understanding of imaging and the clinical experience of surgeons, with strong unpredictability and experience dependence. Surgical navigation systems with real-time positioning and imaging functions, when used in orbital reconstruction surgery, can detect the real-time intraoperative position, avoid risks, and assist in locating the reconstruction position to ensure the accuracy of orbital reconstruction, with the help of a preoperative surgical plan. Many studies have confirmed its effect. Unilateral orbital fracture and orbital floor reconstruction surgery is one of the earliest and most widely used surgical techniques in maxillofacial surgery. Experts from the Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association have fully discussed and formulated this expert consensus on navigation-guided unilateral orbital fracture and orbital floor reconstruction techniques to standardise the clinical surgical procedures and promote its application.
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http://dx.doi.org/10.3290/j.cjdr.a44336DOI Listing
April 2020

Expert Consensus on Navigation-guided Unilateral Delayed Zygomatic Fracture Reconstruction Techniques.

Chin J Dent Res 2020 ;23(1):45-50

The zygoma is located in the medial and lateral parts of the face, supporting the midfacial contour. The forward projection of the zygoma and the zygomatic arch often expose them to injury. Fractures of the zygoma can lead to the displacement of the zygoma and the zygomatic arch, causing facial collapse deformity. For delayed zygomatic fractures, the loss of normal anatomical landmarks caused by the malunion of the fracture lines and remodelling of the bony contour makes it difficult to determine the correct positions of the zygomatic bones. In such cases, ideal and steady outcomes with satisfactory midface symmetry have been difficult to obtain using traditional surgical methods. Nowadays, the application of digital surgical software and surgical navigation helps surgeons to perform accurate preoperative simulations to obtain ideal three-dimensional virtual surgical plans and achieve accurate reduction by intraoperative navigation systems, which increase the accuracy and predictability of fracture reduction outcomes. Experts from the Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association have fully discussed and formulated an expert consensus on navigation-guided unilateral delayed zygomatic fracture reconstruction techniques to standardise the clinical operation procedures and promote the application.
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http://dx.doi.org/10.3290/j.cjdr.a44335DOI Listing
April 2020

Expert Consensus for the Treatment Algorithm for Navigationassisted Reconstruction of Maxillofacial Deformities.

Chin J Dent Res 2020 ;23(1):33-42

Deformities of the maxillofacial region following trauma and ablative surgery are devastating and not uncommon. Reconstruction of such defects is a surgically challenging procedure. Conventionally, reconstruction of dental arch defects lacks preoperative customised planning and relies heavily on the surgeon experience to ensure optimum surgical outcomes. The restoration of the dental arch shape and function has taken precedence after an extensive tumour resection surgery, especially in the current age of technological advancement. Thus, personalised and accurate reconstruction of dental arch defects has become a new goal. Computer-assisted surgery, especially navigation-assisted surgery, has gained popularity of late, in reconstructing deformities and restoring facial symmetry, appearance and function in the maxillofacial region. This technology provides a clearer three-dimensional visualisation of the area of interest and its relationship with the adjacent vital structures. Together with preoperative virtual surgical planning, it allows more specific and accurate osteotomies, thus reducing the ischemia and total operating times substantially. The risk of complications is also minimised whilst improving the final surgical outcomes. The use of the intraoperative navigation system and other computer-assisted surgical techniques during surgery can significantly improve the precision of the reconstruction of dental arch deformities, and achieve personalised and functional reconstructive goals while enhancing the quality of life of patients postoperatively. The Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association provides the present professional perspective and treatment protocol for navigation-guided reconstruction of dental arch defects, to allow standardisation of the technique while promoting its application among oral and maxillofacial surgeons.
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http://dx.doi.org/10.3290/j.cjdr.a44334DOI Listing
April 2020

Expert Consensus on Procedures and Operations of Navigation-guided Needle Biopsy Techniques for Skull Base Tumours.

Chin J Dent Res 2020 ;23(1):27-32

Skull base surgery is an interdisciplinary subject. The anatomical structures in the skull base related to oral and maxillofacial surgery include the parapharyngeal space, the pterygopalatine fossa and the infratemporal space. This operative area is one of the most challenging surgical areas in oral and maxillofacial surgery due to its deep site, complex anatomy and high risk. Obtaining pathological information of the tumour preoperatively may help surgeons optimise their treatment plan. Needle biopsy is one of the major minimally invasive techniques that allows preoperative pathological results to be obtained. The navigation technology, which is developing rapidly nowadays, provides a reliable assistance for deep tissue biopsy surgery. Experts from the Society of Oral and Maxillofacial Surgery, Chinese Stomatological Association formulated an expert consensus on the procedures and operations of navigation-guided needle biopsy techniques for skull base tumours, so as to standardise and promote the application and operation of navigation-guided needle biopsy for skull base tumours.
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http://dx.doi.org/10.3290/j.cjdr.a44333DOI Listing
April 2020

Selection of Guiding Plate Combined With Surgical Navigation for Microsurgical Mandibular Reconstruction.

J Craniofac Surg 2020 Jun;31(4):960-965

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

Purpose: The present study summarized selection of guiding plate combined with surgical navigation for microsurgical mandibular reconstruction.

Methods: Data from preoperative maxillofacial enhanced computed tomography (CT) scans were imported to ProPlan CMF. The authors performed virtual mandibulectomy and superimposed 3-dimensional (3D) iliac images on mandibular defects. Guiding plates including mandibular fixation device, reconstruction plate, guiding model, and occlusal splint for various mandibular hemimandibular central lateral (HCL) defects were fabricated to fix bilateral residual mandible. The model was scanned, and data were imported into ProPlan CMF and the intraoperative navigation system. Through landmark points upon the guiding plate, position of the residual mandible was determined during surgical navigation. Intraoperative navigation was used to implement the virtual plan. Sagittal, coronal, axial, and 3D reconstruction images displayed by the navigation system were used to accurately determine osteotomy sites and osteotomy trajectory during surgery. Surgical probe guidance was used to mark the osteotomy line and transfer the virtual procedure to real-time surgery. Accuracy was evaluated using chromatographic analysis.

Results: Different guiding plates combined with surgical navigation could be used for various mandibular defects, including mandibular fixation devices for LCL defects, reconstruction plates for LC/L/C defects, and guiding models and occlusal splints for H/L/LC defects (including mandibular ramus). In our study, average and largest shift of the mandible and osteotomy site was <5 mm.

Conclusion: The authors summarized different ways of combining guiding plates with surgical navigation for reconstruction of various mandibular defects, which could improve clinical outcomes of this procedure with high accuracy.
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http://dx.doi.org/10.1097/SCS.0000000000006295DOI Listing
June 2020

Prognostic nomogram for microvascular decompression-treated trigeminal neuralgia.

Neurosurg Rev 2021 Feb 10;44(1):571-577. Epub 2020 Feb 10.

Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

This study aimed to establish an effective prognostic nomogram for microvascular decompression (MVD)-treated trigeminal neuralgia (TN). The nomogram was based on a retrospective cohort study of 1054 patients with TN. During the period 2005-2014, 845 patients at our department treated TN with MVD and served as a development cohort. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The model was externally validated by 209 TN patients during 2014-2016. Multivariate cox analysis suggested that the patient's age, atypical pain, vascular type, number of offending vessels, and second MVD were significant factors influencing the prognosis of MVD-treated TN. The C index of nomogram in the development cohort was 0.767 (95% CI, 0.739-0.794), and 0.749 (95% CI, 0.688-0.810) in the validation cohort. We developed and validated a nomogram to predict 3-year overall remission rate after MVD treatment of TN. The nomogram can be used in clinical trials to determine the likelihood of pain recurrence in TN patients treated with MVD for 3 years to aid in the comprehensive treatment of TN.
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http://dx.doi.org/10.1007/s10143-020-01251-0DOI Listing
February 2021

Double-Barrel Fibula Flap Versus Vascularized Iliac Crest Flap for Mandibular Reconstruction.

J Oral Maxillofac Surg 2020 May 13;78(5):844-850. Epub 2020 Jan 13.

Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address:

Purpose: The double-barrel fibula flap and vascularized iliac crest flap are both commonly used for mandibular reconstruction. The present study compared the usage and reconstruction outcomes of transplanted bone with these 2 methods.

Patients And Methods: The data from 30 patients who had undergone mandibular osteotomy and reconstruction were retrospectively reviewed. Of the 30 patients, 20 received a vascularized iliac crest flap (group A) and 10 received a double-barrel fibula flap (group B). The following variables were compared between the 2 groups: volume of bone flap (VBF), volume of effective bone flap (VEBF; ie, overlap between the volume of the ideal mandible [VIM] and the VBF), usage of the bone flap (VEBF divided by the VBF), mandibular reconstruction rate (VEBF divided by the VIM), volume of needless bone flap (VNBF; ie, VBF minus VEBF; the VNBF included the volume of needless buccal bone flap [VNBBF] and the volume of needless lingual bone flap [VNLBF]), percentage of alveolar crest restoration (PACR; ie, effective bone flap width divided by ideal alveolar crest width), and height of the bone flap (HBF). The independent-samples t test and the χ test were used to compare the variables between the 2 groups. Statistical significance was at P ≤ .05.

Results: Usage of the bone flap and the length of the mandibular defect were significantly greater in group B than in group A (P = .039 and P < .001, respectively). The VBF, VNBF, and VNLBF were significantly greater in group A than in group B (P < .001 for both). The mandibular reconstruction rate, VNBBF, PACR, HBF, and tooth implantation rate were comparable between the 2 groups.

Conclusions: The double-barrel fibula flap can effectively restore the height of the alveolar crest, reconstruct longer mandibular defects, and provide a better buccal and lingual appearance compared with the vascularized iliac crest flap. Although the vascularized iliac crest flap can provide sufficient bone quantity, it must be contoured to the mandible.
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http://dx.doi.org/10.1016/j.joms.2020.01.003DOI Listing
May 2020

A high neutrophil-to-lymphocyte ratio predicts hemorrhagic transformation of large atherosclerotic infarction in patients with acute ischemic stroke.

Aging (Albany NY) 2020 02 6;12(3):2428-2439. Epub 2020 Feb 6.

Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Increasing evidence suggests that inflammation is associated with the development of acute ischemic stroke (AIS). The neutrophil-to-lymphocyte ratio (N/L) is an important marker of inflammation and is highly correlated with mortality in stroke patients in recent studies. The N/L of patients who experience hemorrhagic transformation (HT) after AIS is know, but any relationship between N/L and large artery atherosclerosis (LAA) remains unclear, this is our present topic. We enrolled 185 patients with LAA-type HT in the development cohort from a prospective, consecutive, hospital-based stroke registry to this end. We matched these patients to 213 LAA patients who did not develop HT as controls. The incidence of HT after LAA was significantly greater (P<0.01) in patients with higher N/L. We developed a predictive nomogram (incorporating age, systolic blood pressure, the National Institutes of Health Stroke Scale, and the N/L) for LAA patients. The predictive power was good (area under the curve, AUC: 0.832, 95%CI: 0.791-0.872). Our findings were further validated in a validation cohort of 202 patients with AIS attributable to LAA (AUC:0.836, 95%CI:0.781-0.891). In summary, a high N/L is associated with an increased risk for HT after LAA.
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http://dx.doi.org/10.18632/aging.102752DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041750PMC
February 2020

Regeneration of the Neocondyle After Free Fibular Flap Reconstruction of the Mandibular Condyle.

J Oral Maxillofac Surg 2020 Mar 20;78(3):479-487. Epub 2019 Nov 20.

Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address:

Purpose: Shifting of the flap position after condylar reconstruction with free fibular flaps is known to occur, but its long-term effects on postoperative esthetic outcomes have not been sufficiently reported. Therefore, in this study, we evaluated the long-term morphologic stability of the free fibular flap neocondyle.

Patients And Methods: This was a retrospective cohort study. The primary outcome variables were neocondyle regeneration and neocondyle position including the distance between the glenoid fossa and the initial neocondyle (Fo-Co), the distance between the glenoid fossa and the stable neocondyle (Fo-Co'), and shifting of the neocondyle (defined as the distance between the stable neocondyle and the initial neocondyle). The primary predictor variable was time. The other variables were age, gender, diagnosis, and number of fibular segments. Correlation analysis between the predictor variables and outcome variables was performed.

Results: The sample was composed of 26 patients (11 male and 15 female patients) with a mean age of 31 years. Diagnosis and number of fibular segments were significantly associated with Fo-Co and Fo-Co' (P < .05). Among the 26 patients, only 11 showed neocondyle regeneration at follow-up (group A) whereas 15 did not (group B). Neocondyle regeneration was significantly associated with patient age (P < .01). Stable Fo-Co and stable time were significantly associated with neocondyle regeneration (P < .05). The mean stable time was significantly shorter in group A (3.64 ± 1.12 months) than in group B (6.67 ± 3.85 months) (P < .05), and the mean Fo-Co' was significantly shorter in group A (13.65 ± 3.94 mm) than in group B (20.68 ± 8.87 mm) (P < .05).

Conclusions: The possibility of neocondyle regeneration is higher in pediatric patients than in adults. Neocondyle regeneration could result in the movement of the neocondyle toward the glenoid fossa with a shorter stable time, which could improve neocondyle repositioning. Repositioning of the neocondyle with free fibular flaps for mandibular condyle defects is a self-adaption process for temporomandibular joint function.
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http://dx.doi.org/10.1016/j.joms.2019.11.009DOI Listing
March 2020

Scoring system for selective tracheostomy in head and neck surgery with free flap reconstruction.

Head Neck 2020 03 4;42(3):476-484. Epub 2019 Dec 4.

Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.

Background: Selective tracheostomy is an effective but invasive airway management method for patients undergoing head and neck free flap reconstruction. Studies have shown that not all patients need tracheostomy. Several systems evaluating the need for tracheostomy have been proposed, but none is used clinically.

Methods: A total of 533 cases underwent head and neck free flap reconstruction at Peking University School of Stomatology were reviewed for system development. Another 131 cases undergone the same surgery were included for system verification. Patients' demographic and surgical-related information were analyzed.

Result: A total of 321 cases in the development cohort and 68 cases in the system cohort underwent tracheostomy. The score was estimated: score = ∑(|log OR|). Patients scoring >3 required tracheostomy, those scoring <2 should avoid tracheostomy, and those scoring 2 or 3 need further evaluation.

Conclusion: This scoring system can help determine the need for selective tracheostomy in patients undergoing head and neck free flap reconstruction.
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http://dx.doi.org/10.1002/hed.26028DOI Listing
March 2020

Global Vectors Representation of Protein Sequences and Its Application for Predicting Self-Interacting Proteins with Multi-Grained Cascade Forest Model.

Genes (Basel) 2019 11 12;10(11). Epub 2019 Nov 12.

Department of Information Systems, King Abdulaziz University, Jeddah 21589, Saudi Arabia.

Self-interacting proteins (SIPs) is of paramount importance in current molecular biology. There have been developed a number of traditional biological experiment methods for predicting SIPs in the past few years. However, these methods are costly, time-consuming and inefficient, and often limit their usage for predicting SIPs. Therefore, the development of computational method emerges at the times require. In this paper, we for the first time proposed a novel deep learning model which combined natural language processing (NLP) method for potential SIPs prediction from the protein sequence information. More specifically, the protein sequence is de novo assembled by . Then, we obtained the global vectors representation for each protein sequences by using natural language processing (NLP) technique. Finally, based on the knowledge of known self-interacting and non-interacting proteins, a multi-grained cascade forest model is trained to predict SIPs. Comprehensive experiments were performed on and datasets, which obtained an accuracy rate of 91.45% and 93.12%, respectively. From our evaluations, the experimental results show that the use of amino acid semantics information is very helpful for addressing the problem of sequences containing both self-interacting and non-interacting pairs of proteins. This work would have potential applications for various biological classification problems.
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http://dx.doi.org/10.3390/genes10110924DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896115PMC
November 2019

Synaptic Dysfunction in Human Neurons With Autism-Associated Deletions in PTCHD1-AS.

Biol Psychiatry 2020 01 29;87(2):139-149. Epub 2019 Jul 29.

Developmental and Stem Cell Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Background: The Xp22.11 locus that encompasses PTCHD1, DDX53, and the long noncoding RNA PTCHD1-AS is frequently disrupted in male subjects with autism spectrum disorder (ASD), but the functional consequences of these genetic risk factors for ASD are unknown.

Methods: To evaluate the functional consequences of PTCHD1 locus deletions, we generated induced pluripotent stem cells (iPSCs) from unaffected control subjects and 3 subjects with ASD with microdeletions affecting PTCHD1-AS/PTCHD1, PTCHD1-AS/DDX53, or PTCHD1-AS alone. Function of iPSC-derived cortical neurons was assessed using molecular approaches and electrophysiology. We also compiled novel and known genetic variants of the PTCHD1 locus to explore the roles of PTCHD1 and PTCHD1-AS in genetic risk for ASD and other neurodevelopmental disorders. Finally, genome editing was used to explore the functional consequences of deleting a single conserved exon of PTCHD1-AS.

Results: iPSC-derived neurons from subjects with ASD exhibited reduced miniature excitatory postsynaptic current frequency and N-methyl-D-aspartate receptor hypofunction. We found that 35 ASD-associated deletions mapping to the PTCHD1 locus disrupted exons of PTCHD1-AS. We also found a novel ASD-associated deletion of PTCHD1-AS exon 3 and showed that exon 3 loss altered PTCHD1-AS splicing without affecting expression of the neighboring PTCHD1 coding gene. Finally, targeted disruption of PTCHD1-AS exon 3 recapitulated diminished miniature excitatory postsynaptic current frequency, supporting a role for the long noncoding RNA in the etiology of ASD.

Conclusions: Our genetic findings provide strong evidence that PTCHD1-AS deletions are risk factors for ASD, and human iPSC-derived neurons implicate these deletions in the neurophysiology of excitatory synapses and in ASD-associated synaptic impairment.
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http://dx.doi.org/10.1016/j.biopsych.2019.07.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948145PMC
January 2020

Oral Squamous Cell Carcinoma with Metastasis to the Parotid Lymph Node.

Chin J Dent Res 2019 ;22(3):175-179

Objective: To increase the awareness of oral squamous cell carcinoma (OSCC) metastasis to the parotid region and the characteristics of these cases, and to evaluate the outcomes and provide treatment suggestions.

Methods: A retrospective study was conducted among the OSCC patients with metastasis to the parotid gland at the Peking University School and Hospital of Stomatology from 2000 to 2015. The demographic data and the medical records including primary tumour, treatment protocol, follow-up information and outcomes were collected and analysed.

Results: A total of 10 patients with parotid metastasis (out of 1358 OSCC patients) were included in the study. The incidence of parotid metastasis was relatively low (0.74%). All the cases were poorly differentiated (Grade II/III) and the primary sites were in an advanced stage (T3/4). Parotid metastasis occurred frequently following neck dissection and radiotherapy, and the inferior parotid lymph nodes were most commonly involved. Surgery and radiotherapy were mainly salvage protocols for parotid metastasis. The 5-year survival rate of these patients was 38.9% by the Kaplan-Meier method.

Conclusion: OSCC has the potential to metastasise into the parotid lymph nodes. The salvage rate and prognosis were relatively poor. Removing of the parotid tail along with the neck dissection is recommended for OSCC patients.
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http://dx.doi.org/10.3290/j.cjdr.a43111DOI Listing
October 2019

Hsa_circ_101882 promotes migration and invasion of gastric cancer cells by regulating EMT.

J Clin Lab Anal 2019 Nov 16;33(9):e23002. Epub 2019 Aug 16.

Ultrasonic Department of Linyi Central Hospital, Linyi, China.

Background: At present, gastric cancer (GC) is a serious threat to human life and health. Non-coding circular RNAs (circRNAs) have been found abnormal expression in multiple tumors. However, circRNAs remain largely unknown in tumor progression. In the present study, we mainly examined the expression, function, and molecular mechanisms of a new circRNAs (hsa_circ_101882) in GC.

Materials And Methods: The expression of hsa_circ_101882 in GC tissue, corresponding adjacent normal tissues, and GC cell lines was examined by RT-PCR. The function of hsa_circ_101882 in GC was evaluated by MTT assay, cell migration, and invasion assay, colony formation assay, and flow cytometric assay. The effect of hsa_circ_101882 on epithelial-to-mesenchymal transition (EMT)-related gene expression was detected by RT-PCR and Western blot.

Results: Hsa_circ_101882 expression levels were significantly increased in GC tissue and GC cell lines. Functionally, low expression of hsa_circ_101882 revealed anti-tumor effects via inhibiting cell growth, migration, and invasion and promoting cell apoptosis. Mechanically, the dysregulated expression of hsa_circ_101882 affects EMT signaling pathway, which was examined by detecting E-cadherin, N-cadherin, vimentin, and Snail expression levels.

Conclusions: Therefore, our research reveals that hsa_circ_101882 is considered a metastasis promoter by activating EMT and may serve as a critical oncogene and potential new biomarker in GC.
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http://dx.doi.org/10.1002/jcla.23002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6868453PMC
November 2019

Surgical effect and electrophysiological study of patients with hemifacial spasm treated with botulinum toxin or acupuncture before microvascular decompression.

Clin Neurol Neurosurg 2019 Sep 12;184:105417. Epub 2019 Jul 12.

Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Center for diagnosis and treatment of cranial nerve diseases, Shanghai Jiaotong University, Shanghai, China. Electronic address:

Objective: We investigated patients with hemifacial spasm (HFS) who received a botulinum toxin (BT) injection or acupuncture before receiving microvascular decompression (MVD) to determine whether it affects the success rate of surgery. Abnormal Muscle Response (AMR) and Compound Motor Action Potential (CMAP) are commonly used as electrophysiological monitoring methods in surgery, and we will compare the differences between these patients in this regard.

Patients And Methods: A total of 539 patients with HFS underwent MVD treatment in our department between January 2014 and June 2017. Among them, 83 patients had received BT injection before surgery and were recorded as BT group. Eighty-three patients underwent acupuncture before surgery and were recorded as acupuncture group. Five patients received both BT injection and acupuncture before surgery and were recorded as mixed group. A total of 368 patients who had not received any treatment before surgery were recorded as simple MVD group. We calculated the immediate and long-term remission rates after surgery. AMR and CMAP monitoring were routinely performed during surgery.

Results: Immediate remission rate after surgery was 96.4% (80/83) in BT group, 100% (83/83) in acupuncture group, 100% (5/5) in mixed group, and 95.1% (350/368) in simple MVD group, and the immediate remission rate of BT group is significantly higher than that of simple MVD group (p = 0.04). Long-term remission rate: the remission rates of the four groups were 94.0% (78/83), 97.6% (81/83), 100.0% (5/5) and 92.7%(341/368), respectively, and there is no statistical difference between them (p > 0.05). The amplitude of one branch or several branches of CMAP on the affected side was lower than the healthy side in BT or acupuncture treatment patients.

Conclusions: A preoperative BT injection or acupuncture treatment do not reduce the postoperative remission rate of HFS patients treated with MVD, and the amplitude of CMAP on the affected side was lower than the healthy side.
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http://dx.doi.org/10.1016/j.clineuro.2019.105417DOI Listing
September 2019

The Risk Factors for Facial Numbness After Microvascular Decompression in Patients With Trigeminal Neuralgia.

J Craniofac Surg 2019 Nov-Dec;30(8):e710-e713

Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine.

Object: Microvascular decompression (MVD) is the most popular surgical procedure for treating Trigeminal neuralgia (TN). In this article, the authors conducted a large case series in which patients underwent MVD for TN, and focus on surgical outcomes, intraoperative findings, complications and risk factors.

Methods: From January 2017 to June 2017, a total of 84 patients with TN were treated with MVD in our department. The authors retrospectively analyzed the surgical outcomes and postoperative complications of these patients. Risk factors were analyzed by binary logistic regression analysis.

Results: Of the 84 patients, 69 had complete postoperative symptom relief (BNI I-II). A total of 28 patients developed postoperative facial numbness (BNI III-IV) and 1 patient died intraoperatively. With binary logistic regression analysis, significant risk factors for postoperative Facial numbness (FN) were longer operation time (odds ratio [OR] 1.153, P <0.05) and longer hospital stay (OR 1.371, P <0.05). The patients' age, the length of the disease, the gender, and the side of the disease did not affect the occurrence of postoperative FN.

Conclusions: The study found that patients with TN treated with MVD had a good response rate after surgery. The incidence of FN after surgery is not low, and longer duration of surgery and longer hospital stay are risk factors for FN. In the case of ensuring the success rate of surgery, reducing unnecessary operations, reducing the operation time, will help to reduce the occurrence of FN.
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http://dx.doi.org/10.1097/SCS.0000000000005711DOI Listing
January 2020

Prognosis Comparison of Different Branches of Trigeminal Neuralgia.

World Neurosurg 2020 Jan 25;133:e1-e5. Epub 2019 Jun 25.

Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Center for Diagnosis and Treatment of Cranial Nerve Diseases, Shanghai Jiao Tong University, Shanghai, China. Electronic address:

Objective: We explored the remission rate of different branches of the trigeminal nerve after microvascular decompression.

Methods: A retrospective analysis of trigeminal neuralgia patients treated with microvascular decompression in our department from January 2014 to January 2015 was conducted to investigate the prognosis and factors affecting prognosis.

Results: One-hundred and fifty-five patients with trigeminal neuralgia including 2 patients with V1 division had a remission rate of 100% at 1 day, 3 months, 1 year, and 3 years after surgery; 93.5%, 93.5%, 90.3%, and 67.7% of patients with V1-2 division. The patients with V1-3 division had rates of 91.7%, 87.5%, 75.0%, and 66.7%; V2 division rates were 88.4%, 81.4%, 76.7%, and 69.8%; V2-3 division rates were 90.2%, 90.2%, 87.8%, and 75.6%; and V3 division were 100%, 100%, 92.9%, and 92.9%.

Conclusions: Postoperative remission rate of non-V2-related branches (V1, V3) are higher than V2-related branches (V2, V1-2, V1-3, V2-3).
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http://dx.doi.org/10.1016/j.wneu.2019.06.115DOI Listing
January 2020

Outcomes of Zygomatic Complex Reconstruction With Patient-Specific Titanium Mesh Using Computer-Assisted Techniques.

J Oral Maxillofac Surg 2019 Sep 23;77(9):1915-1927. Epub 2019 Mar 23.

Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address:

Purpose: Zygomatic complex defects after extensive maxillectomy can cause severe esthetic and functional deformities. Patient-specific titanium mesh fabricated using a computer-assisted technique is a promising method for such midface reconstruction. The aim of this study was to evaluate the application and clinical outcomes of this technique.

Patients And Methods: This was a retrospective study that included 9 patients with zygomatic complex defects after extensive maxillectomy from 2015 through 2017 at the authors' institution. A 3-dimensional stereo model was obtained based on mirror images of the unaffected side to fabricate a patient-specific titanium mesh using computer-assisted design and manufacturing. Titanium mesh was used to restore the contour of the zygomatic complex with free flap reconstruction after tumor resection. Anterolateral thigh flaps were used in 8 cases and a myocutaneous fibula flap was used in 1 case. Symmetry of the zygomatic complex was evaluated by measuring the zygomatic eminence on the postoperative computed tomogram, and complications were recorded during follow-up visits. Facial symmetry was self-evaluated and scored.

Results: Mean duration for follow-up was 27.3 months (range, 15 to 39 months). Mean deviation of the zygomatic eminence between the reconstructed and unaffected sides was 1.4 ± 0.5 mm. No significant difference was noted in the zygomatic eminence between the reconstructed and unaffected sides (P = .591). Titanium mesh exposure occurred in only 1 patient after radiotherapy. There were no other remarkable complications. All patients were satisfied with their postoperative facial symmetry.

Conclusion: Patient-specific titanium mesh fabricated using a computer-assisted technique was an alternative option for extensive zygomatic complex reconstruction, resulting in acceptable clinical outcomes. A study with a larger sample and long-term follow-up is needed for the observation of long-term outcomes and risk of titanium mesh-related complications.
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http://dx.doi.org/10.1016/j.joms.2019.03.014DOI Listing
September 2019
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