Humans ; Oral Surgical Procedures

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:To develop an automatic and continuous distraction osteogenesis technique by using totally embedded distractor of nickel titanium (Ni-Ti) shape-memory alloy for the reconstruction of mandibular ramus. Methods:16 adult New Zealand rabbits were used in the experiment. Mandibular ramus and condyle on one side was removed to create a 1.5 cm segmental defect. A transport disc was created by "L" shape osteotomy at the end of the remnant ramus and Ni-Ti distractor was fixed and totally embedded in tissues. The rabbits were sacrificed 2 months after operation and the mandibles were harvested.The bone reconstruction were studied with radiographic and histological examination. Results: 2 months after operation all the animals were alive and mandible function kept well.The Ni-Ti distractors were self-activated and performed distraction osteogenesis automatically. The mandibular ramus achieved preliminary reconstruction. Histological examination showed bone regeneration in the distraction area. Conclusions: Ni-Ti distractor can fulfill automatic and continuous distraction osteogenesis.

[Objective]To explore the effect of spinal cord injury(SCI) repair by peripheral nerve combined with activitied macrophages graft.[Method]Fistly the preparation of the activated macrophages and fabrication of the peripheral nerve were done.81 BALB/C mice were grouped in A,B,C,D groups randomly after their spinal cord were hemi-resected.20 mice of group A were dealed with activated macrophages graft;20 of group B were dealed with peripheral nerve graft;21 of group C were transplanted both two graftes;20 of group D were contral group.Each of the 4 groups was respectively divided into 3 subgroups randomly.7 of subgroup 1 were investigated by their restoration of the motor function and improvement of the somatosensory evoked potential(SEP).7 of subgroup 2 were tabken for histological examination.The spinal cords were fixed and cut into longitudinal frozen sections,and were immuneostained and stained with hematoxylin and eosin(HE).The numbers of cells or neurofilaments were counted under microscope.6 of subgroup 3(7 of C3)were used as complement ones.All the results were recorded from 1 to 12 weeks postoperative and analyzed statistically using the SPSS 12.0 software package.[Result]The BBB scale and the SEP wave:there was a significant difference between group C1 and the other three groups,there was a significant difference between group A1,B1 and D1,too(ONE WAY ANOVA,P

Objective To explore the protective effect of ligustrazine on the ischemia-reperfusion injury of rat liver. Methods Ninety-six healthy SD rats were divided randomly into three groups: sham operation group, ischemia-reperfusion group(I/R group) and ischemia plus ligustrazine reperfusion group(therapy group).The plasm ALT,AST and LDH were measured before operation,at thirty minutes,six hours and twenty-four hours after operation. One week survival and liver pathological change of every group were observed, and the hepatocyte apoptosis index was measured simultaneously.Results One week survival of therapy group was higher than that of I/R group ( P

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 To investigate the possible pathogenesis of the cognitive function in unilateral frontal bottom laceration by follow-up study in patients after one month of the onset. Methods MMSE, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Montreal Cognitive Assessment (MoCA), Wisconsin Card Sorting Test (WCST) scales were used to evaluate neurocognitie function in 42 patients after one month of onset of unilateral frontal bottom laceration and 45 normal controls. The wave amplitude and the latency of the endogenous composition N2, P3 of P300 were measured at the cognitive potential instrument. Level of AChE was determined by ELISA and active AChE was analyzed by the ration analyses. Stepwise multivariate regression analyzed the correlation of the overall cognitive function and the lever and active of AChE. Results The cognitive test scores in patients were significantly worse than those in normal controls. The ability of recite sentences, fluency of words, reading, understanding language,cognitive transfering decreases in the left frontal bottom laceration patients (Group A, 23 cases), while the ability of attention, action, organization, graphics depicting, abstract epitoming, logical thinking were all seriously impaired in the patients with right frontal bottom laceration (Group B, 19 cases). The latency of the endogenous composition N2, P3 in patients ( Group A: (322. 4 ± 17.0), (410. 1 ± 19.9) ms; Group B:( 308.4 ± 15.6), (385.5 ± 17.4) ms) is more lengthen ( F = 4. 084, P = 0. 018; F = 3.467, P = 0. 038 )than the normal controls ( (268.6 ± 14. 7 ), ( 369. 2 ± 15. 4 ) ms) and the wave amplitude is lower ( F =2. 986 ,P =0. 047 ;F =3. 313 ,P =0. 041 ). The latency of N2 ,P3 in Group A of is more lengthen than Group B, while the wave amplitude is higher. The difference of the active of AChE in patients and control groups had no statistical significance, however, the level of AChE in two groups had statistical significance. The comparison of the active and the total AChE in patients has also not statistical significance. The correlation of the overall cognitive function has the linear regression with the parts of the brain and the level of AChE ( rY1.2 = 0. 584, P = 0. 039; rY2.1 = 0. 726, P = 0. 017 ). The standardized regression coefficients showed the level of AChE has the biggest influence to the overall cognitive function ( |Beta| =0. 3601, rY2.1 =0. 726).Conclusions AChE may be one of the important factors in the cognitive function after frontal bottom laceration. The specific damages of cognitive function in unilateral frontal bottom laceration patients closely relate with the lesion locations in the injured frontal bottom laceration.

We report the treatment process of a patient with acute vertebral artery occlusion complicated by top of the basilar artery syndrome after arterial thrombolysis.The top branches of vertebral artery and basilar artery were patent after the mechanical and drug thrombolysis again. The prognosis of the patient was good. The modified Rankin scale score was 1. It suggested that in addition to the arterial local thrombolysis was effective to the lesions themselves, it also had good efficacy for the newly developed embolic complications during the process of thrombolysis.

BACKGROUND:TiNi shape memory alloy(TiNi-SMA)distractor can be buried completely,there is no time delay and it is different from other distractors previously used.Therefore,it is necessary to reevaluate the osteogenetic time and quality.OBJECTIVE:To investigate the quality of the alveolar ridge augmented by TiNi-SMA distractor by bone mineral density (BMD)and biodynamics tests of new-formed bone.DESIGN:Randomized controlled observation.SETTING:Department of Stomatology of General Hospital of Chinese PLA.MATERIALS:Twelve healthy adult male mongrel canines(ranged from 21 to 26 kg)were provided and bred by Medical Experimental Animal Center of General Hospital of Chinese PLA.All the animals were accorded with the requirements of the quarantine and animal ethnics.Self-made distractors were used in the study.XR-36 Dual Energy X-Ray Absorptiometry (Norland,USA)and 858 Mini Bionix Ⅱ Biomaterial Testing Machine(MTS,USA)were used in the study.METHODS:The experiments were performed at the Medical Experimental Animal Center of General Hospital of Chinese PLA from July 2000 to May 2004.The animals were grouped into group Ⅰ(3 months group)and group Ⅱ(6 months group)randomlv with 6 animals in each group.The left mandible was used as experimental side and the right was used as COntrol side.The canines were kilied after anaesthesia at 3 or 6 months later in both groups.After the mandible samples were cut,the BMD of three points in the distraction gap,above the distraction gap and below the distraction gap were measured by dual energy X-ray.Compressive biomechanics test was performed in the middle of the distraction area of the experimental side and the corresponding area of the control side to detect compressive stress and the modulus of elasticity.MAIN OUTCOME MEASURES:①BMD of the distraction area of the experimental side and the control side in the group Ⅰand group Ⅱ.②Compressive strength and modulus of elasticity of the mandibles of the experimental side and the control side.RESULTS:All of the 12 experimental canines were included in the final analysis,no drop-out.BMD determination:BMD was lower in above the distraction gap of the mandibles of the experimental side than in the control side in the group Ⅰ (t=-2.898,P＜0.05).There was no significant difference in BMD between both sides in the group Ⅱ(P＞0.05).Compressive biomechanics test:Compressive stress and the modulus of elasticity of the mandibles on the experimental side were lower than on the control side in the group Ⅰ(t=-3.274,-3.534,P＜0.05).All indexes increased by some degree in the group Ⅱ compared to the group Ⅰ (P＞0.05).CONCLUSION:The new bone is strong enough for later repair such as implantation after distraction osteogenesis using TiNi-SMA distractor.

Objective To compare total gastrectomy jejunal loop P-type esophagus jejunum Roux-en-Y anastomosis(PRY) and non-type esophageal transection of the jejunum improved Roux-en-Y anastomosis(URY) two different digestion Road reconstruction on the nutritional status of patients and gastrointestinal symptoms. Methods 152patients with total gastrectomy required of gastric cancer patients immediately divided into two groups ,76 patients in each group ,respectively PRY and URY surgical reconstruction of digestive tract, were followed up for 12 months, two groups were compared on nutritional status and gastrointestinal symptoms. Results PRY operation time and postoperative complication rate we re more than URY group(all P ＜0.05) ;two groups 12 months after the mortality and weight changes, hemoglobin, total protein, albumin, and all reflux esophagitis the incidence rate was no significant difference (all P ＞ 0.05); after 3 months and 6 months in both groups food intake ＜ 300ml/second person, eating frequency ＞5 times/d and the difference in the incidence of RSS had statistical significance (all P ＜ 0.05). Conclusion URY surgical reconstruction of digestive tract and maintain the continuity of muscle conduction,and the surgical procedure was simple,a good prognosis and relatively PRY more reasonable in terms of surgical procedures.