Objective To provide anatomical basis of the zygomatic branch of the facial nerve for the rhytidectomy. Methods The clinical surgical anatomy of the zygomatic region was studied bilaterally on 12 embalmed cadaveric head specimens and 2 fresh cadavers. Results The zygomatic branches came out of the parotid and divided into 2 or 5 branches (66.70 %), three branches (25.00 %), or multiple branches (8.80 %). 91.67 % of the rami superficialis was observed, and its branches had three types. The path of the rami superficialis could be located beforehand in a plane section. The rami superficialis and the rami profundus had various anastomosis. Conclusions Zygomatic branches divide into the rami superficialis and the rami profundus according to crossing the zygomatic majar musle. The rami superficialis distribute on the upper one third of the zygomatic majar musle, and it accounts for 91.67% in the group. It can be labeled before rhytidectomy to avoid the nerve injury.

BACKGROUND:Morinda has been reported to promote the proliferation, the secretion of alkaline phosphatase and osteocalcin, and mRNA expression of transforming growth factor of osteoblasts. However, little information is available addressing the effects of Morinda on receptor activator of nuclear factor-κB expression in osteoclasts in rats with osteoporosis. OBJECTIVE:To study the effects of Morinda on receptor activator of nuclear factor-κB expression in osteoclastsofosteoporosis rats. METHODS:Thirty Sprague-Dawley rats were equaly and randomly divided into Morinda and 17β-estradiol groups. Rat models of osteoporosis were established by bilateral ovariectomy, and then 5 mL of Morinda decocta(1.0mmol/L)and 17β-estradiol (1×10-6mmol/L) were administered intragastricaly to rats in Morinda and 17β-estradiol groups for 3 consecutive months, respectively. Primary osteoclasts were isolated from rats in both groups, andthen cultured for 3, 6 and 9 days folowed by TRAP staining andcelcounting. Bone mineral density of the proximal and distal femur, urine and serum levels of Ca2+and progesterone, and receptor activator of nuclear factor-κB expression in osteoclasts ofrats in both groups were determined. RESULTS AND CONCLUSION:Osteoclast fusion was reduced in Morinda group. In contrast, number of osteoclastswas increased andcels becamemore maturein the17β-estradiol group. Bone mineral density of the proximal and distal femur bilateraly, urine and serum levels of Ca2+and progesterone were significantly increased, while receptor activator of nuclear factor-κB expression was significantly decreased in osteoclasts in Morinda group compared with 17β-estradiol group (P< 0.05). These results indicate that Morinda reduces receptor activator of nuclear factor-κB expression in osteoclasts in osteoporosis rats, thereby inhibiting the development and progression of osteoporosis.

No abstract available.
Lymphomatoid Papulosis* ; Pregnancy*

Objective To explore the indications of simultaneous pancreas-kidney (SPK) transplantation for type 2 diabetes mellitus (DM) combined with end-stage renal disease by comparing the outcome of patients with type 1 and type 2 DM combined with end-stage renal disease after renal transplantation.Methods 109 patients accepting SPK from January 2008 to July 2016 in our center were divided into two groups according to the types of DM:T1DM (n =36),and T2DM (n =73).The basic characteristics of recipients,outcome,and pancreas and kidney functions after operation were compared between two groups.Results There was no significant difference in 5-year survival rate and surgical complications between two groups although recipients of T2DM group were older and had higher BMI than T1DM group.But rejection rate was higher in T1DM group.Conclusion SPK for T2DM recipients will not increase the surgical risk and can get good long-term outcome.

Objective To investigate the feasibility of restoration of cartilage defect with silk fibrin/chitosan(SF-CS)biological scaffold compound by induced bone marrow mesenchymal stem cells (BMSCs)in the elderly rabbits.Methods BMSCs were extracted,cultured and induced to differentiate,then inoculated into SF-CS three-dimensional scaffold restoration.54 rabbits(aged 16-18months)were divided into scaffold restoration,single scaffold and control groups(n=18 per group).The right knee joint was used for building cartilage defect model and implanted by scaffolds.General observation,tissue staining and modified Wakitani histological scoring were performed at 4,8 and 12weeks after operation.Results SF-CS scaffold was structured by multiple interlinked pores.The average pore size was 151.72 μm.The porosity was(92.72±4.78)％.The imbibition rate was (141.10± 6.87)％.BMSCs was grown well and proliferated dynamically in SF-CS scaffold after induction.At 12 weeks,the cartilage defect was basically repaired,type Ⅱ collagen was positively expressed and the scaffold was almost assimilated in scaffold restoration group.In single scaffold group,the cartilage defect was repaired mainly by fiber tissue,type Ⅱ collagen was less expressed and the scaffold almost degraded while the cartilage defect was repaired badly in control group.The scaffold restoration group was superior to single scaffold and control groups(P＜0.05)in improving the Wakitani score.Conclusions The SF-CS scaffold as BMSCs carrier may restore cartilage defect in knee joint of the elderly rabbits.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.

Adult ; Aged ; Boronic Acids ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; complications ; drug therapy ; Pyrazines ; therapeutic use ; Renal Insufficiency ; complications ; drug therapy

Humans ; Microvessels ; Neovascularization, Pathologic ; Neovascularization, Physiologic ; Plaque, Atherosclerotic ; pathology

Objective To evaluate the safety and clinical efficacy of retroperitoneal laparoscopic partial nephrectomy (LPN) in patients with incidental renal cell carcinoma.Methods Twenty-six patients with T1 incidental renal cell carcinoma treated with retroperitoneal LPN from Dec.2011 to Oct.2013 were analyzed retrospectively.The operation time,warm ischemia time,intraoperative blood loss,complications and prognosis of perioperative periods were collected.Results All 26 cases were operated successfully without conversion to open or other surgery.The operation period was 90-190 minutes.Blockage of renal artery was applied in all 26 cases,and the warm ischemia time was 15-30 minutes.The intraoperative blood loss was 100-360 ml.The drainage was removed 3-7 days postoperatively,and the hospitalization period was 7-12 days.All cases were clear cell renal cell carcinoma by pathological examinations,and showed negative surgical margins.No complications such as postoperative bleeding,inflammation and leakage of urine were occurred.All cases had normal renal function during the follow-up of 3-25 months without local recurrence or distant metastasis.Conclusion Retroperitoneal LPN for the treatment of T1 incidental renal cell carcinoma is worthy of application with the advantages of safety,minimal invasiveness,fewer complications,quick recovery and good nephron-sparing functional recovery.

Objective To investigate the merit and demerit for surgical excision of polycystic kidney at the same time of kidney transplantation and to analyze its effect on complications and prognosis.Methods The data of 63 cases of polycystic kidney were retrospectively analyzed.Among the 63 recipients,43 recipients were combined with polycystic liver,and 2 with pancreatic cyst.For the large size of polycystic kidney,in 31 patients with hematuria or urinary tract infection,the polycystic kidney was resected during kidney transplantation(kidney-cut group,31 cases).The polycystic kidneys in The remaining 32 cases were preserved during kidney transplantation (reservation group).All the recipients were treated with CsA(Tacrolimus),mycophenolate mofetil (MMF)and prednisone after transplantation.The general conditions of recipients,the occurrence of delayed graft function(DGF),acute graft rejection.operative complications and infection,and survival rate of recipients and grafts were observed.Results Operative time in kidney-cut group was (300±31)min,and perirenal drainage tube duration was(4.6±1.4)days in kidney-cut group,significantly longer than in reservation group(both P＜0.01).Volume of red blood cells transfusion in kidney-cut group was(4.31±1.05)U,significantly more than reservation group(P＜0.01).29.0%(9/31)recipients in kidney-cut group had surgical complications,significantly higher than reservation group(6.2 0A,2/32)(P＜0.05).The ineidence of urinary tract irdection was 31.2% (10/32)in reservation group,significantly higher than in kidney-cut group(6.5%,2/31,P＜0.05).12.5%(4/32)patients in reservation group needed surgical excision of polycystic kidney after kidney transplantation due to polycystic kidney infection.In 24 recipients with preoperative high blood pressure in each group,the blood pressure of 8 recipients(33.3%)in kidney-cut group returned to normal,compared with only 2 recipients(8.3%)in reservation group(P＜0.05).The incidence of DGF,incidence of acute rejection,human/kidney 1-and 5-year survival rate between 2 groups had no statistically significant difference.Conclusion As long as the detailed operation.it is safe to resect patient's polycystic kidney during renal transplantation,but there are no effects on patient/kidney survival rate.