To evaluate the incidence of sub-clinical neck metastasis and its surgical treatment in patients with oral squamous cell carcinoma (OSCC) without clear evidences for lymph nodes metastasis, a total of 205 patients with OSCC in N0 and N1 stage(UICC 1987′s classification) were included in the study.Their clinical and histopathological files were retrospectively studied and patients were followed up after operation. Histopathological positive lymph nodes were found in 10.8%(13/120) of patients,and postoperative lymph nodes metastasis occurred in 16.5%(14/85) of patients without neck dissections.There were no significant differences between N0 and N1 groups.Neck recurrence occurred in 11.9%(5/42) of patients after functional neck dissections.The rate was higher in patients with bucal lesions.Patients undergoing radical neck dissections also had neck recurrence with an incidence of 6.4%.But most of them occurred on contralateral side. It suggested that subclinical metastasis of OSCC with clinically negative neck lymph nodes could not be neglected.Functional neck dissection should include the lymph nodes of level Ⅲ,especially for cancers located on bucca mucosa and tongue.Bilateral neck dissection is necessary for large primary lesions spreading to the contralateral side.

To evaluate the incidence of sub clinical neck metastasis and its surgical treatment in patients with oral squamous cell carcinoma (OSCC) without clear evidences for lymph nodes metastasis, a total of 205 patients with OSCC in N0 and N1 stage(UICC 1987′s classification) were included in the study.Their clinical and histopathological files were retrospectively studied and patients were followed up after operation. Histopathological positive lymph nodes were found in 10 8%(13/120) of patients,and postoperative lymph nodes metastasis occurred in 16 5%(14/85) of patients without neck dissections.There were no significant differences between N0 and N1 groups.Neck recurrence occurred in 11 9%(5/42) of patients after functional neck dissections.The rate was higher in patients with bucal lesions.Patients undergoing radical neck dissections also had neck recurrence with an incidence of 6 4%.But most of them occurred on contralateral side. It suggested that subclinical metastasis of OSCC with clinically negative neck lymph nodes could not be neglected.Functional neck dissection should include the lymph nodes of level Ⅲ,especially for cancers located on bucca mucosa and tongue.Bilateral neck dissection is necessary for large primary lesions spreading to the contralateral side.

Objective:The infusion pumps are high risk equipment in clinic, the clinical risk of it is much higher the general medical equipment and diagnostic. Methods:FLUKE lagu1 was used to calibrate the Smiths infusion pumps in different conditions. Results: As a result, the quality control of it is particularly important. We introduce a method to calibrate model 1200 infusion pump from the angle of quality control. Conclusion: Infusion pump quality control testing should accord with clinical practice. Infusion pumps calibrated to provide security for the clinical infusion therapy and reduce the medical risk.

Objective To investigate the relationship between the Schatzker types and postoperative knee function in tibial plateau fractures .Methods Totally 120 patients with tibial plateau fracture from January 2010 to December 2014 were selected and performed the Schatzker classification according to the X‐ray film ,CT and three dimensional reconstruction .They were divided into 6 groups .The postoperative knee function in each group was followed up and the statistical analysis was conducted .Results The excellent grade distribution of knee function by Kruskal‐Wallis test had statistical difference among 6 groups(P<0 .05) ,in the fur‐ther pairwise comparison ,the significant differences were found between the group 1 and 2 with the group 4 ,5 and 6(P<0 .05) . Conclusion The Schatzker types of tibial plateau fractures is closely correlated with the postoperative knee function .The knee function scores of type Ⅳ ,Ⅴ and Ⅵ are obviously poor .

Objective:To analyze pharmaceutical procurement model of hospital, and explore better pharmaceutical procurement model so as to suit the development of modern hospital.Methods: Combined with the current situation of pharmaceutical procurement in domestic medical organization in recent years to analyze the current problems that existed in pharmaceutical procurement of hospital management.Results: Aimed at the problems that existed in procurement management model in current hospital, the reasonable suggestions have been proposed, and these suggestions have provided reference and experience forpharmaceutical management and procurement in hospital.Conclusion: Pharmaceutical procurement is the material basis of pharmaceutical supply of pharmaceutical trading enterprise, and it is the start point of pharmaceutical circulation and distribution, and it also is the first important step. Especially, aimed at the institutional reform of separating pharmacy from clinic in Beijing, the normalization of pharmaceutical procurement management will be very important effect in working practice.

Medical devices are widely used in the treatment of diseases,health care and rehabilitation process as modern science and technology products,and become an important means in the field of modern medicine. How to ensure that medical devices are used safe and effective is the common problem in production,management,use and monitoring.

Objective Oral and Maxillofacial trauma Diagnosis and Treatment Expert system (OMDTES)was used in maxillofacial trauma PBL teaching to improve the quality of PBL teaching,and perfeet the assessment criteria, Methods OMDTES was applied in two procedures of maxillofacial injury PBL teaching activity:the preparation of lesson plan and assessment criteria.Then a questionnaire was designed to assess the effect of this new mode of PBL teaching.Results The new teaching model is welcomed by students and can improve students'interest in learning,the satisfaction of teaching and ameliorate method of assessment of PBL teaching.Conclusion Applying OMDTES in oral and maxinofacial injury PBL teaching has special advantages in raising the leavnevs'activity of learning,training their ability of chnical thinking and analysis.And it is worthy of further research and amelioration.

Objective To evaluate the treatment and clinical outcome of pancreatic pseudocysts.Methods Clinical data of 53 pancreatic pseudocyst patients treated from Jan 2008 to Oct 2014 was retrospectively analyzed.Results 9 cases underwent CT-guided percutaneous catheter drainage,among them 3 cases underwent reoperation.8 cases underwent endoscopic ultrasonography-guided transmural drainage,including transgastric approach in 7,transduodenal approach in 1,Procedures in all these 8 cases were successful and pseudocyst disappeared completely without complication.Surgical procedures were performed in 36 cases,3 by external drainage,1 of the 3 underwent reoperation;11 cases underwent cystgastrostomy,with 2 suffering from postopertative gastrointestinal bleeding;3 cases underwent cystduodenostomy;19 cases underwent Roux-en-Y cystojejunostomy,with 1 suffering from postopertative gastrointestinal bleeding.Follow-up ranged from 4 months to 6 years,there was no cyst recurrence.Conclusion The treatment of pancreatic pseudocysts is diversified and should be individualized.Internal drainage is the mainstay of treatment,preferably through endoscopic ultrasonography-guided transmural drainage,leaving difficult cases to open cystojejunostomy.

BACKGROUND:Scholars have studied the three-dimensional finite element models of tibial plateau fractures with different fixation methods, but the research on three-dimensional finite element model of tibial plateau fracture fixation was not much. OBJECTIVE:To analyze the biomechanical characteristics of external fixator for tibial plateau fracture by using the three-dimensional finite element method. METHODS:The tibial plateau fracture models treated with locking plate fixation and external fixator were established. Three-dimensional finite element analysis was used to analyze the stress distribution and displacement of two kinds of models. RESULTS AND CONCLUSION:(1) The average displacement value and the maximum displacement value of tibial plateau fracture external fixator model group were smal er than that of tibial plateau fracture locking plate fixation model group, but no significant difference was found (P>0.05). (2) X axial displacement value and Y axial displacement value were smal er in the tibial plateau fracture external fixator model group than in the tibial plateau fracture locking plate fixation model group, but no significant difference was found (P>0.05). (3) The stress of tibial plateau fracture locking plate fixation model focused on the junction of the screw and bone tissue as wel as the junction of plates and screws. The maximum stress value of tibial plateau fracture locking plate fixation model (173 MPa) was greater than that of tibial plateau fracture external fixator model (86 MPa). The stress of tibial plateau fracture external fixator model was scattered. Obvious stress concentration did not occur. The stress at the junction of the clamp and the nail and the junction of the connecting rod and screw was higher than that at other regions, and was a weak link in the clinical mechanics. (4) Results showed that external fixation for tibial plateau fractures had better stability and fixing strength as compared with the internal fixation.

Objective:To seek the possibility of using internally installed curved mandibular distractor to repair the partial mandibular curved defect.Methods:A curved mandibular defect was sectioned in each of 3 adult dogs.The distractor designed by our own group based on the steel ball conducted force was implanted.After 7 days of latency,the distraction was performed at the rate of 0.5 mm × 2 times per day,followed by 3 months consolidation period.The osteogenesis was evaluated by general observation,X-ray examination and HE staining.Results:No complication was observed after operation and during distraction.The new bone healed well into a curved shape.The X-ray examination revealed that the transport disc moved along with the predesigned rail curve.HE staining clearly showed neo bone formulation zone between the mature trabecular and connective tissue.Conclusion:The internal distractor based on the steel ball conducted force can realize the curved distraction osteogenesis of posteriormandibular.