BACKGROUND:Maxilofacial bone and periodontal tissue defect is one of the important diseases that affect human functionality and aesthetic appearance, and bone tissue engineering becomes the main means to repair maxilofacial and periodontal tissue defects. Currently, the basic mode is constructed by the combination of co-culture of seed cels and cels, scaffolds and micro-environment. Pre-vascularization and rapid osteogenesis of tissue-engineered bone can reduce implant necrosis and absorption, and improve repair success rate. OBJECTIVE:To summarize the new progress of bone tissue engineering used in the oral and maxilofacial and periodontal tissue in the past 5 years. METHODS:CNKI database and PubMed database from 2010 to 2015 were searched using the keywords of “oral and maxilofacial, bone tissue engineering, bone regeneration, vascularization, genetic modification, seed cels, support material, microenvironment” in Chinese and English, respectively. After elimination of independent and repetitive studies, 68 articles were included in result analysis. RESULTS AND CONCLUSION: The tissue-engineered bone has achieved tremendous progress in the repair of oral and maxilofacial and periodontal tissue defects. The three-dimensional scaffold with gene-modified seed cels can effectively promote the vascularization, improve the osteogenic effect and increased the probability of success in mandibular defect repair. In addition, tissue-engineered bone implantation into the alveolar ridge defects or fresh extraction fossa can effectively restore and preserve alveolar ridge height and width, to ensure a good bone condition for subsequent restorative treatment. After the implantation of tissue-engineered bone, different external environmental stimuli could be loaded at defect sites, and the extracelular matrix components or signal pathway could be adjusted to change the process of vascularization. Vascularization is a premise condition for the establishment of an effective blood circulation to ensure the success of scaffold implantation.

砄bjective:To study the biocompatability and absorption of ? tricalcium phosphate doped A10 (? TCP A) and ? tricalcium phosphate doped SrO (? TCPs) in the implantation into mandible.Methods:Pieces of ? TCP A,? TCPs or ? TCP (? tricalcium phosphate) in the size of 10 mm?3 mm? 2.5 mm were implanted into the defects of mandible in 48 rabbits.The specimens were obtained 2,4,12 and 24 weeks after operation respectively,measured for size and observed morphologically, the content of Ca,P and S in the specimens was measured with EDAX.Results:The absorption (%) of ? TCP A,? TCPs and ? TCP in 24 weeks was 22,28 and 40 respectively.Bone formation was found in the interface between the mandible and materials in 4 weeks and the amount of new bone in the materials increased in 12～24 weeks.No inflammation was found.The amount of Ca,P and S in the materials was close to that in the mandible of rabbit in 24 weeks.Conclusion:? TCP A and ? TCPs are biocompatable for implantation into bone deffect.

?Objective:To study the inductive effect of absorbable crystalline glass (ACG) and absorbable crystalline glass powder(ACGP) , in osteogenesis.Methods:Samples of ACG,ACGP and ? TCP in the size of 10 mm?3 mm?2.5 mm were prepared and implanted subperiosteally into the mandible deffects in 48 rabbits .Specimens obtained 2,4,12,and 24 weeks after implantation were observed with X ray film,measurement of area of crosssection energy dispersive X ray analysis(EDX),light and scanning electron microscopes.Results:Bone formation was found in 12 weeks and increased in 24 weeks in all implannts.The degradation (%) of ACG,ACGP and ? TCP in 24 weeks were 33,80 and 40 respectively.24 weeks after implantation the Ca ++ content (% of wt)in ACG,ACGP,? TCP and rabbit mandible were 20.54,20.29,19.96 and 19.71;the P ++ content (% of wt)10.54,10.51,10.72 and 10.96,respectively.Conclusion:ACG and ACGP are degradable,biocompatible and osteoinductive.

Objective:To evaluate the analgesic effects of two kinds of preoperative peripheral nerve block drug in patients with tri-geminal neuralgia undergoing radiofrequency thermocoagulation(RFT)of gasserian ganglion.Methods:90 patients with classic trigemi-nal neuralgia of the 3rd branch were scheduled to undergo RFT of the gasserian ganglion and were randomly divided into 3 groups(n =30).The patients in group N without nerve block were served as the controls.The patients in group A and B were treated by the nerve block of inferior alveloar with 2 ml of 2% lidocaine hydrochloride and 2 ml of compound lidocaine hydrochloride for each respectively 2 d before RFT.The pain control was studied by VAS method before and 24,48 h after nerve blocking and during pucture for RFT.Re-sults:Compared with the control group,24 h after nerve blocking,the average pain and the most pain VAS value of group A and B were significantly reduced(P <0.01);sleep quality and analgesia satisfaction were improved in group A and B(P <0.05).48 h after nerve blocking the pain relief and sleep quality improvement of group B were more than those of group A(P <0.05).In addition,during RFT puncture the pain intensity of group A and B were less than that of group N(P <0.05).The pain control in group B was more effective than that in group A.Conclusion:A single peripheral nerve block with long-term narcotic compound lidocaine hydrochloride can be an effective way to relieve preoperative and operative pain for RFT of trigeminal neuralgia.

Objective To compare the clinical effects of botulinum toxin injection and radiofre quency thermal rhizotom in the treatment of primary hemifacial spasm.Methods A total 118 primary hemifacial spasm patients were randomly divided into two groups,who were received botulinum toxinA injections and radiofrequency thermal rhizotom treatment,respectively.Patients were followed up,and the curative effect,complications and recurrence rates of the two treatments were statistically compared.Results The early curative effect (1 month) for primary hemifacial spasm in botulinum toxin injection group was better than that in radiofrequency thermal rhizotom treatment group:recurrence rate of long-term (6 months) was 72.5 ％,but caused a very low risk of facial paralysis; radiofrequency thermal rhizotom treatment had a long-term effect as compared with botulinum toxin injection,6 months recurrence rate was 21.4 ％,with a low rate of postoperative facial paralysis.Conclusions Botulinum toxin injections is higher in short-term effectiveness and smaller in side effects as compared with the treatment of radiofrequency thermal rhizotom. However,radiofrequency thermal rhizotom treatment is more stable in the prospective efficacy.

Objective To establish the swine acute heart failure model for surgical experiment, and evaluate the heart function by continuous cardiac index (CCI). Methods Swine heart failure model was attempted to establish by coronary ligation in six swines. CCI was obtained by Swan-Canz catheters and Vigilance monitor, and hemodynamic, biochemical and ultrasonocardiographic results were utilized to evaluate the changes of heart function. Results Five swines accomplished the experiment. Compared with basic status, there were significant differences in mean arterial pressure (MAP) , pulmonary artery systolic pressure (PASP), mixed venous oxygen saturation ( SVO_2) and CCI for swines with heart failure ( P < 0.05) , there was no significant change in biochemical parameters, while left ventricle ejection fraction ( LVEF) significantly decreased (P<0.05). Conclusion CCI is feasible in monitoring and evaluating heart function of animal model. The swine acute heart failure model established by coronary ligations can meet the needs of surgical experiment in principle.

Objective: To develop an HPLC method for the simultaneous determination of 3 anthraquinones components in Knoxia valerianoides.Methods: The separation was performed on a Waters Xbridge C18column(250 mm×4.6 mm,5 μm), the mobile phase A was 0.05% phosphoric acid, and acetonitrile served as the mobile phase B, and the analysis was with gradient elution;the flow rate was 1.0 ml·min-1;the detection wavelength was 280 nm;the column temperature was 30℃.Results: The linearity of lucidin, 3-hydroxymorindone and knoxiadin was 0.147-29.400 μg·ml-1 (r=0.999 6), 0.126-25.200μg·ml-1 (r=0.999 9) and 0.135-27.000μg·ml-1 (r=0.999 5), and the average recovery was 98.50%(RSD=1.20%), 98.72%(RSD=0.73%) and 101.10%(RSD=1.12%)(n=6), respectively.Conclusion: The developed method for the simultaneous determination of 3 components can be used to control the quality of Yunnan Knoxia valerianoides.

Objective To investigate the clinicopathological characteristics and postoperative prognosis analysis of intra-thoracic localized Castleman disease (LCD).Methods The clinical data of 9 patients with intra-thoracic LCD who accepted surgical treatment were retrospectively analyzed.There were 5 males and 4 females,with age of (32.8 ± 10.9) years.Two patients complained of chest pain,1 patient suffered from paraneoplastic pemphigus,and the rest were diagnosed by physical examination.Four cases were diagnosed with LCD by preoperative CT examination.Results All patients underwent surgical resection.Four patients were performed open surgery and 5 patients had video assisted thoracic surgery.All patients accepted radical surgery.But 2 of these patients had postoperative complications.One patient was the injury of phrenic nerve and another was pericardial effusion.Patho-histological showed hyaline vascular type of Catleman disease in all patients.All patients survived without recurrence during the follow-up for 2-53 months.Conclusions Intra-thoracic is rare and liable to misdiagnosed.For increasing the preoperative diagnosis rate of LCD,the combined application of imaging tests is important,and clinicians and radiologists should also enhance the awareness of this disease.Complete surgical resection of the tumor is the best therapeutic alternative for intra-thoracic LCD.

Objective To evaluate the effect of video- assisted thoracoscopic pulmonary segmentectomy in patients with isolated pulmonary arteriovenous fistula (PAVF). Methods A retrospective analysis was performed on 10 patients with PAVF in the department of thoracic surgery of the first affiliated hospital of Nanjing Medical University between January 2010 and December 2016. Computed tomography angiography (CTA) and three-dimensional reconstruction were performed before operation, and all patients accepted video-assisted thoracoscopic pulmonary segmentectomy. Results The diagnosis of PAVF was identified by CTA, with maximum diameter of tumor of 3.0- 5.0 cm. No perioperative mortality or postoperative complications were observed including bleeding, hemoptysis, serious air leakage, and bronchopleural fistula. The lesions were completely removed in all 10 patients, and no patients converted to open surgery intraoperatively. Blood gas analysis showed that oxygen partial pressure before operation, in the first day after operation and the third month after operation was (62.5 ± 6.7), (70.2 ± 4.8) and (75.4 ± 4.8) mmHg (1 mmHg = 0.133kPa) respectively; which was significantly increased successively (P<0.05). After a follow-up time of 3-30 months, no recurrences were observed. Conclusions Video- assisted thoracoscopic pulmonary segmentectomy guided by preoperative CTA and three-dimensional reconstruction is a very effective method for the treatment of isolated PAVF.

Objective:To explore the effects of a dysphagia management plan based on the family empowerment theory led by specialist nurses on the swallowing function, the incidence of aspiration and the caregiver ability of elderly stroke patients with dysphagia.Methods:Using the convenient sampling method, a total of 102 elderly stroke patients with dysphagia in Department of Neurosurgery in the Second Affiliated Hospital of Wenzhou Medical University from January to December 2019 were selected as the research objects. Patients were divided into the experimental group and the control group by simple randomization method, with 51 cases in each group. Patients in the control group were given regular oral muscle exercise training, oral sensory training, breathing training, and direct feeding guidance based on the swallowing function. In the experimental group, a research team led by rehabilitation specialist nurses was established on the basis of routine guidance. The research team provided targeted swallowing disorder management programs according to the risk level of aspiration combined with empowerment theory. Two weeks after intervention, the swallowing function (Standardized Swallowing Assessment score) , the incidence of aspiration (aspiration pneumonia and irritant cough) and caring ability of caregivers (Chinese version of Caring Ability of Caregivers Scale score) were compared between the two groups.Results:In this study, 5 objects were lost to follow-up, including 2 in the experimental group and 3 in the control group. Finally, 49 patients in the experimental group and 48 patients in the control group completed the study. After 2 weeks of intervention, the swallowing function score of the experimental group was (29.18±4.49) , lower than that of the control group (33.33±4.44) , and the difference was statistically significant ( P< 0.05) . In the experimental group, there was 1 case of aspiration pneumonia and 8 cases of irritant cough. In the control group, there were 6 cases of aspiration pneumonia and 14 cases of irritant cough. The incidence of aspiration in experimental group was lower than that in control group, and the difference was statistically significant ( P< 0.05) . After intervention, the total score of caring ability of caregivers in the experimental group was (25.02±2.64) , while that in the control group was (34.35±4.41) , and the difference was statistically significant ( P< 0.05) . Conclusions:The family empowerment program led by specialist nurses can improve the swallowing function of elderly stroke patients with dysphagia, reduce the incidence of aspiration pneumonia and irritating cough and improve the caring ability of caregivers.