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Plunging ranula is rare and manifests as the submandibular or submental cystic mass, without intra-oral abnormality. It usually causes misdiagnosis and malpractice. This article reported a case of plunging ranula that appeared as a massive mass located behind the left ear. A 6-year-old child presented with recurrent left retroauricular swelling over six months without obvious inducement. The mass showed repeatedly swelling and persistent skin ulcers. Physical examinations described a fluctuant, nontender mass behind the left ear whose size was about 5 cm×5 cm×3 cm. The skin upon the surface of the mass was thin and red, and overflowed yellow slimelike contents. Computed tomography (CT) showed an extensive cystic lesion in the left neck. After local incision and drainage the mass was shrink. With the primary clinical diagnosis of branchial cyst, the patient underwent mass resection through postauricular incision. During the operation, the fistula was traced to the area around the sublingual gland, and the posto fully confirm through a clinical character, and usually easy to be misdiagnosed as other tumors, like lymphatic malformation, venous malformations, etc. Radiographic examination and/or puncture fluid observation are required for identification. "Egg-white", wire-drawing mucous secretion is the most important characteristic in clinical diagnosis of sublingual gland cyst. However, if sublingual gland resection, i.e. removal of the source of cyst fluid is performed, a good prognosis can be achieved.OBJECTIVE To explore the possibility of the Smile Lite MDP (Smile Lite Mobile Dental Photograph) portable dental photography system applying in anterior teeth aesthetic photography, and to provide the chance to simplify aesthetic photography process and facilitate communication among patients, dentists and dental technitians. METHODS The Smile Lite MDP photography system combined with the smartphone were used to photograph the front occlusal phase photos of anterior teeth. The photographic conditions including the color temperature parameter, the Smile Lite MDP light position and the intensity settings were explored. The best photographic conditions were chosen by blind evaluation within experienced dentists and technicians through the method of the visual analogue scale/score (VAS) evaluation, which went through statistical analysis to figure out the optimum photograghic conditions. Smile Lite MDP photography system was used to photograph the front occlusal phase photos of anterior teeth under the optimum paght photography parameters. Therefore, Smile Lite MDP portable dental photography system was considered to be a simple and easy photographic tool in clinical work.OBJECTIVE To analyze the clinical data of patients undergoing intravenous sedation in oral and maxillofacial surgery, to understand the epidemiological characteristics, to evaluate the efficacy and safety of intravenous sedation for oral surgery, and to summarize our experience. METHODS We retrospectively reviewed the clinical data of patients undergoing intravenous sedation between January 2010 and December 2018 in the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology. The gender, age, source, disease types, the values of perioperative vital signs, the use of sedatives and analgesics, duration of surgery and sedation, effect of sedation during the operation and the postoperative anterograde amnesia were analyzed. learn more RESULTS A total of 2 582 patients experienced oral surgery by intravenous sedation. The peak age was 3.5 to 10 years and between 21 to 40 years. Supernumerary teeth (38%, 981/2 582) and impacted third molars (30%, 775/2 582) were the major disease types, and otherpostoperative anterograde amnesia rates of local anesthesia injection, surgical incision and dental drill during surgery were 94% (2 431/2 582), 92% (2 375/2 582) and 75% (1 452/1 936). CONCLUSION Intravenous sedation on the oral and maxillofacial surgery is effective and safe, can make the patients more comfortable, and should be further promoted and applied.OBJECTIVE To summarize the preliminary experience of hybrid operation for the treatment of symptomatic long-segment chronic internal carotid artery occlusion (CICAO) without stump. METHODS Clinical data of 12 patients of symptomatic long-segment CICAO without stump undergoing hybrid operation treatment from July 2015 to December 2017 were retrospectively analyzed. The safety and efficacy of hybrid operation for the treatment of symptomatic long-segment CICAO without stump were preliminarily assessed. CICAO was defined as occlusion time being more than 4 weeks. The primary outcome was defined as any stroke (including ischemic or hemorrhagic) or deaths from any cause after hybrid operation within 30 days. The secondary outcome was defined as successful revascularization and occurrence of >50% in-stent restenosis during the follow-up period. RESULTS In this group, the symptomatic long-segment CICAO of 11 patients were successfully recanalized. Technical success rate was 91.7% (11/12). The main complication rate was 8.3% (1/12). This patient encountered iatrogenic internal carotid artery cavernous sinus fistula caused by micro-guide wire in the midway of the hybrid operation, the proximal segment of this internal carotid artery was ligated and the iatrogenic internal carotid artery cavernous sinus fistula disappeared in the following digital subtraction angiography image. No patient encountered hemorrhagic stroke and ischemic stroke. No death complications occurred. In this group 10 patients of them were followed up. The follow-up period ranged from 10 to 32 months [mean, (19±9) months]. During the follow-up period, 1 patients developed in-stent restenosis and improved after reoperation of percutaneous transluminal angioplasty by the right size balloon without stenting treatment. CONCLUSION Hybrid operation for the treatment of highly screened patients with symptomatic long-segment CICAO without stump is safe and effective, could reduce the incidence of complications and improve procedural success rate.OBJECTIVE To investigate the outcomes of breast reconstruction with employing improved techniques throughout the tissue expander/implant two-stage breast reconstructed process, which involved the tissue expander placement, the saline filling intraoperatively and postoperatively, the implant selection, and the permanent implant replacement. METHODS In this study, 68 patients who had been provided immediate or delayed tissue expander/implant two-stage breast reconstruction with autologous fat injection post-mastectomy in Peking University Third Hospital from April 2014 to September 2018 were involved, and the relevant information was analyzed retrospectively. The enhancements of the techniques, involving the incision selection, the expander placement, the principle of expansion, the management of capsule, the prosthesis selection, and the assisted reconstruction method were summarized, and the reconstruction outcomes were evaluated objectively through three-dimensional surface imaging. RESULTS Among the 68 patilacement of expander, the rapid expansion of chest soft tissue, the release of capsule tension, the application of sizer in prosthesis selection, and the assisted autologous fat grafting.OBJECTIVE To investigate the types and distribution of musculoskeletal ultrasonographic changes of the symptomatic joints, their correlations with clinical manifestations in systemic lupus erythematosus (SLE) patients, as well as the differences of ultrasonographic changes from Rhupus syndrome [SLE overlapping with rheumatoid arthritis (RA)] patients. METHODS In the study, 114 SLE patients who complained of arthralgia or arthritis from May 2014 to August 2017 and 15 Rhupus syndrome patients were recruited for ultrasound evaluation. Ultrasound scans of the symptomatic joint areas were completed. The correlation between ultrasonographic changes and clinical characteristics was analyzed. Additionally, ultrasound changes of bilateral wrists and hands of the SLE patients were compared with those of the Rhupus syndrome patients. RESULTS In a total of the 114 SLE patients with 1 866 joints scanned, synovial hyperplasia, tenosynovitis, erosion, and osteophytes were all observed. Synovial hyperplasia was more often obia and erosion were more common in the Rhupus syndrome patients (73.3% vs. 36.2%, P=0.08; 66.7% vs. 14.5%, P=0.03) with significantly higher grey scale scores (7.4±6.4 vs. 1.6±4.1, P=0.04) than in the SLE patients. CONCLUSION Variety of changes could be observed by ultrasound in different joint areas of SLE patients. The ultrasonographic changes and clinical manifestations did not always correspond to each other. Synovial hyperplasia and erosion was more common in Rhupus syndrome patients.OBJECTIVE To explore the prognosis factors that influence the postoperative survival rate in patients with malignant solitary pulmonary nodules and to provide a reference for the prognosis risk stratification of early lung cancer patients. METHODS In this study, we retrospectively reviewed 172 patients who were admitted to Peking University First Hospital from April 2006 to December 2013. All cases were radiologically defined as solitary pulmonary nodule and were pathologically confirmed to be stage Ia non-small cell lung cancer after surgical procedure. The patients' clinical and follow-up data were summarized and analyzed. The relevance between survival time and factors that may affect patients' prognosis was evaluated, which included gender, age, clinical symptoms, smoking history, comorbidity index, tumor biomarkers, nodule type, type of surgery, nodule location, nodule histopathological type, nodule size, histopathological differentiation grade, proliferating cell nuclear antigen Ki-67 expression level a007-1.035). CONCLUSION For patients with malignant solitary pulmonary nodules, with pathological defined as stage Ia non-small cell lung cancer, age, gender and Ki-67 expression levels might be important prognostic factors. Comprehensive consideration of Ki-67 proliferation index and clinical pathological features may help to stratify the prognosis more accurately and guide the selection of appropriate therapeutic strategies, which needs to be verified by multi-center studies.OBJECTIVE To evaluate the effects of cardiopulmonary fitness on arteriosclerotic cardiovascular disease (ASCVD) events in patients with different risks of ASCVD. METHODS This study enrolled 544 non ASCVD patients who underwent cardiopulmonary exercise testing in Peking University Third Hospital from September 2016 to April 2018. ASCVD overall risk assessment was conducted according to "Chinese Guidelines for the Prevention and Treatment of Adult Dyslipidemia". Peak oxygen uptake (VO2peak), the classic indicator of cardiopulmonary fitness, was accurately determined by cardiopulmonary exercise testing in all the patients. All of the patients were followed up clinically. RESULTS In the study, 506 patients completed the follow-up (250 lowrisk patients, 93 moderaterisk patients and 163 highrisk patients). The median follow-up period was 19 months (9-28 months), and 51 patients developed ASCVD events during the follow-up period, of whom, 33 cases developed myocardial infarction, unstable angina or coronary revascularization, and 18 cases ischemic stroke, transient ischemic attack or carotid vascular revascularization.
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