This paper described the progress in therapeutics of drug dependence by opioids, involved in usages of opiate receptor agitations, non-opiate receptor agitations, non-drug treatment, and immunosuppressive therapy.

AIM: To explore the effects of Compound Yi-Zhi (YZC) on learning and memory capacity and free radical metabolism in D-galactose induced mice dementia model. METHODS: The mice dementia model was induced by a daily D-galactose 0.15 g?kg -1 sc for 45 d and after 5 d D-galactose injection, the mice were treated with three doses of YZC once a day for 40 d. In order to find out the influence of YZC on the models learning and memory capability and free radical metabolism system, Y-maze test was introduced for the former and superoxide dismutase (SOD) and malondialdehyde (MDA) tests for the latter. RESULTS: Compared with the D-galactose model group, three doses of YZC administration ( 0.108, 0.217, 0.433 g?kg -1) were all shown to significantly reduced the times of learning/memory in Y-maze test from 31.35? 8.97/ 17.12? 5.57 to 19.67? 8.07/ 11.27? 6.65, to 14.00? 6.84/ 8.29? 5.95, and to 11.41? 5.99/ 6.24? 4.97, respectively. For SOD, the administrations of 0.108 and 0.433 g?kg -1 YZC could increase the activity of SOD from 17.69? 3.14 to 26.94? 4.46, and to 21.33? 3.63 nU?mg -1 pro. While for MDA, all the three doses of YZC could decrease the level of MDA from 4.08? 0.88 to 2.82? 0.75, to 2.10? 0.42, and to 2.35? 0.39 nmol?mg -1 pro in the mice brain tissue, respectively. CONCLUSION: YZC can improve the D-galactose induced learning and memory dysfunction, and the action may be related to the improvement of antioxidase activity in the model mice brains.

Objective To investigate the preventing and curative value of endoscopic injectim sclerotherapy underlying endoscopic variceal ligations in the treatment of the patients suffering form esophageal varix recurrence.Methods The endoscopic injection sclerotherapy was performed to the patients whose esophageal varix varnished or nearly varnished after the endoscopic variceal ligation.Results There were sinificant differences (P ＜ 0.05 ) between the group of the endoscopic variceal ligation combining more dose laurornacrogol and the group of the single endoscopic variceal ligation at the recurrence rate of bleeding.No severe complications were observed during the treatments.Conclusion The endoscopic injection clerotherapy of more amount doses lauromacrogol after the endoscopic variceal ligation can signiticantly reduce residual esophageal varix after the endoscopic variceal ligation and dday esophageal varix recurrrence.

Objective To evaluate the efficacy of intravenous methylprednisolone for prevention of tracheal intubation-related laryngopharyngeal complications.Methods Three hundred ASA Ⅰ or Ⅱ patients,aged 20-50 yr,weighing 50-80 kg,undergoing elective surgeries,requiring tracheal intubation under general anesthesia,were included and randomized into 5 groups (n =60 each).Methylprednisolone 40 and 80 mg were injected intravenously at 30 min before induction of anesthesia in groups Ⅰ and Ⅱ,respectively,while the equal volume of normal saline was given instead in group Ⅲ.Methylprednisolone 40 and 80 mg were injected intravenously at 30 min before extubation in groups Ⅳ and Ⅴ,respectively.The sore throat,hoarseness and cough were recorded within 24 h after extubation and the severity was evaluated at 1 and 24 h after extubation.Results There was no significant difference in the incidence and severity of sore throat,hoarseness and cough between the five groups (P ＞ 0.05).Conclusion Intravenous methylprednisolone can not effectively prevent tracheal intubation-related laryngopharyngeal complications in patients.

BACKGROUND: Three-dimensional printing to prepare a digital model can improve the accuracy of orbital fracture repair, and has a good clinical prospect.OBJECTIVE: To evaluate the effect of individualized titanium mesh based on the digital model in the reconstruction of orbital fracture.METHODS: Twelve cases of orbital fracture were admitted at the Hospital of Stomatology, Southwest Medical University from January 2014 to October 2015. CT scanning in axial, coronal, sagittal planes and three-dimensional reconstruction were performed routinely in all cases preoperatively. Digital model was designed by 3D printing technology according to the CT data. Individualized titanium mesh was shaped based on the digital model and used to repair orbital fracture. The accuracy of the reconstructed orbit was assessed based on the postoperative CT scan.RESULTS AND CONCLUSION: Postoperative CT scans showed that the implanted individualized titanium meshes were capable of accurately reconstructing the fractured orbit in all the 12 patients, and there was no infection, and titanium mesh loosening, prolapse, and rejection. With healthy eyes as controls, 11 cases of eyeball retraction were corrected completely, and only 1 case was still under correction. Diplopia symptoms disappeared in the 8 of 9 cases, and relieved in the 1 of 9 cases. Seven cases of eye movement limitation recovered postoperatively. To conclude, the individualized titanium mesh has great accuracy to repair orbital fractures in patients without serious complications,which has achieved good clinical outcomes in the orbital reconstruction.

Objective To summarize our experience in the prevention and treatment of accessory hepatic duct injury during operation on biliary tract.Methods The clinical data of 26 cases with accessory hepatic duct were retrospectively reviewed.Results Of 26 cases,the accessory hepatic duct were type I in 38.5%(10/26),and no complications including bile leakage,biliary infection and obstructive jaundice developed after division and ligation of the accessory hepatic duct;26.9%(7/26) were type II,among which,the accessory hepatic duct were injured in 3 cases,but no case developecl complications after relevant treatment;23.0%(6/26) were type III,among which,injury of accessory bile duct occurred in 2 cases.Of them,1 case developed bile leakage and was cured by reoperation.7.7%(2/26) were type IV and 3.9%(1/26) was type V.The cases of type IV and V were not damaged.Conclusions To prevent injury of accessory hepatic duct,pre-and intra-operation identification of the condition is very important,and especially by intraoperative cholangiography.Different types of accessory hepatic duct injury should be treated by different approaches. Accessory hepatic duct of type I might be cut and ligated.Type II accessory bile duct which(enters) the cystic duct and should be protected,but,if damaged,different methods of treatment are used,(depending) on the caliber of accessory hepatic duct.Type III and IV also should be protected,but,when damaged,the accessory hepatic duct should be repaired or performed an internal draining.

ObjectiveTo validate the feasibility and accuracy of right ventricular (RV) volume and systolic function with single cardiac cycle real-time three-dimensional (3D) echocardiography. MethodsThree-dimensional images of RV and left ventricle (LV) were obtained in 122 healthy adults by 3D matrix array transducer. The end systolic volume (ESV), end diastolic volume (EDV), stroke volume (SV) and ejection fraction (EF) were measured by RV analysis and LV analysis software. To validate the reliability of measurement of right ventricle by real-time three-dimensional echocardiography, the correlations of RV functional parameters and multiple parameters (such as age, gender and body surface area) were analyzed. And the correlation and difference between different modalities of left ventricle and right ventricle were compared.Results3D-RVEF was (55.66±13.97)%, 3D-RVEDV was (68.24±40.19) ml, 3D-RVESV was (30.09±19.14) ml and 3D-RVSV was (38.30±26.10) mL. RVSV and RVEF of normal men were larger than those of normal women, but no statistical difference were found [(40.15±26.15) mlvs (36.11±25.60) ml, (55.69±14.57)%vs (55.62±13.36)%, bothP>0.05]. RV related function parameters had no relevant correlation with age (P>0.05). Body surface area was weakly related to RVEDV, RVESV and RVSV (r=0.236, 0.247 and 0.178, allP<0.05). BSA had no correlation with RVEF. 3D-RVSV and 3D-RVEDV were weakly positively correlated with 3D-LVSV and 3D-LVEDV (r=0.215 and 0.201, bothP<0.05). 3D-RVEF and 3D-RVESV were not correlate with 3D-LVEF and 3D-LVESV.ConclusionThe single cardiac cycle real-time three-dimensional echocardiography is a simple and feasible method for assessment of right ventricular function and can quantify right ventricular contractive function precisely.

Objective:To observe the efficacy and safety of individual dose of intravitreal conbercept (IVC) in the treatment of retinopathy of prematurity (ROP) before type 1 threshold.Methods:A retrospective case study. From January to July, 2019, 23 cases (46 eyes) of children with type 1 pre-threshold ROP were included in the study. Among them, 14 cases (28 eyes) were male and 9 cases (18 eyes) were female. The mean gestational age at birth was 28.06±1.73 weeks. The average birth weight was 1.14±0.19 kg. The mean corrected gestational age was 34.38±1.41 weeks at the time of first intravitreal injection of IVC. The axial length (AL) of children was measured by A-mode ultrasound before IVC for the first time. According to the calculation of AL, the corresponding injection dose range was 14.23-16.19, 16.20-17.57, 17.58-18.63 mm and the injection dose of IVC was 0.015, 0.020, 0.025 ml (including IVC was 0.15, 0.20, 0.25 mg, respectively). The first IVC dose was 0.015 ml. On the first day before IVC and on the first and seventh days after IVC, 2 ml of arterial blood was taken from children, serum vascular endothelial growth factor (VEGF) concentration was detected. The follow-up time after treatment was ≥1 year. After one year of follow-up, the effective rate and recurrence rate of IVC for the first time were tested by χ2 tests. The short-term changes of injection times, injection intervals, retinal vascularization time and serum VEGF concentration in children were tested by t test. Results:Retinal neovascularization subsided and vascular buckling decreased in all eyes. Iris neovascularization subsided, 1-3 weeks after IVC for the first time. Within one year after the first IVC, 16 eyes underwent IVC twice with or without new blood vessels at the junction of the vascular area. The average corrected gestational age was 40.56±3.81 weeks. The injection dose of IVC was 0.015 ml and 0.020 ml for 2 eyes and 14 eyes, respectively.The mean interval from IVC for the first time was 40.89±8.99 days. Of the 16 eyes who underwent IVC twice, 8 eyes showed neovascularization again in the retinal area with or without blood vessels. The average corrected gestational age was 43.00±1.41 weeks. The injection dose of IVC was 0.020 ml and 0.025 ml for 3 eyes and 5 eyes, respectively. The mean interval of the second IVC was 28.60±6.07 days. The mean interval from the first IVC was 69.20±12.40 days. At the end of follow-up, all eyes were treated effectively (100%, 46/46). The mean time of retinal vascularization was 46.31±3.42 weeks. The average number of injections was 1.52±0.76. On the first day before IVC and on the first and seventh days after IVC, the average serum VEGF concentrations were 111.21±148.71, 25.60±27.71 and 42.99±38.01 pg/ml, respectively. Serum VEGF concentration was significantly lower than that before IVC on the 1st and 7th day after IVC ( Z=-4.054, -2.779; P<0.05). Serum VEGF concentration was higher 7 days after IVC than 1 day after IVC, and the difference was statistically significant ( Z=-2.505, P<0.05). All eyes were not treated by laser photocoagulation or vitrectomy. No eye complications such as lens opacification, endophthalmitis and retinal detachment related to drugs or treatment methods were found in all patients. Conclusion:Intravitreal injection of individualized dose of IVC is effective in the treatment of type 1 pre-threshold ROP. Seven days after treatment, serum VEGF concentration of patients’serum decreases.

OBJECTIVEThe aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.

METHODSSixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.

RESULTSThe position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.

CONCLUSIONCTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor

Angiography ; Carcinoma ; Free Tissue Flaps ; Humans ; Mouth Floor ; Myocutaneous Flap ; Patient Care Planning ; Reconstructive Surgical Procedures ; Thigh ; Tomography ; Tongue

OBJECTIVEThis study aims to evaluate the effect of customized titanium mesh, which was designed by mirror imaging and rapid prototyping technique, with Medpor applied for orbital fracture with enophthalmos.

METHODSOrbital axial, coronal, and sagittal CT scan, and three-dimension CT examination were performed routinely in. 18 cases of orbital fracture with enophthalmos preoperatively. Based on the CT data, prosthesis model was designed by reverse engineering and rapid prototyping technique. The customized titanium mesh and Medpor were applied for orbital reconstruction and enophthalmos correction. Orbital reduction and globe projection were evaluated by postoperative CT scan and clinical follow-up visits.

RESULTSCT scans revealed that the customized titanium mesh with Medpor had great accuracy to reconstruct the orbital fracture and correct the enophthalmos in all patients without serious complications. The eye and facial appearance and function recovered significantly. No serious complication occurred in the operation and after operation.

CONCLUSIONThe customized titanium mesh, based on mirror imaging and rapid prototyping technique, can accurately reconstruct the orbital fractures with enophthalmos. The application of Medpor can effectively correct enophthalmos and eyeball mobility malformation.

Enophthalmos ; therapy ; Facial Bones ; Humans ; Orbit ; Orbital Fractures ; surgery ; Polyethylenes ; Postoperative Period ; Prostheses and Implants ; Reconstructive Surgical Procedures ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed