Objective:To explore the therapeutic efficacy of a new access to internal rigid fixation for mandibular condylar fracture. Methods: 7 patients with 9 unilateral mandibular condylar fractures were treated with preauricular beeline incisions. The two trunks of facial nerve were dissected and separated along the surface of the superficial temporal veins. Mandibular ramus periosteum was dissected. The fracture segments were reduced and fixed under sufficient exposure. Results: This operation access provided a sufficient exposure and was convenient for reduction and fixation. All the patients recovered effectively.Conclusion: This surgical approach is one of the feasible methods for reduction and fixation of mandibular condylar fracture.

Objective:To investigate the effect of fluvastatin sodium (FS ) on MMP-9 expression in tongue squamous carcinoma Tca81 1 3 cells.Methods:Immunofluorescence method and Western blot were used to detect the level of MMP-9 expression in Tca81 1 3 cells treated by different concentration of FS for 24 h,the data were statistically analyzed.Results:MMP-9 expression in FS treated cells was significantly reduced(P<0.05)compared with control cells.With FS concentration increase the protein expression decreased in a dose-dependant manner detected by the 2 mothods.Conclusion:Fluvastatin Sodium can dose-dependantly inhibit the expression level of MMP-9 in Tca81 1 3 cells.

Objective To summary the application of computer aided three-dimensional visualization technique in different kinds of mandibular detects reconstruction with vascularized free fibular flap.Methods Five patients diagnosed of recurrent mandibular ameloblastoma underwent the virtually operation by software with a thin-slice CT scan,which determined shape and position of the free flap,and preoperative resin model and modules were designed and prefabricated.Then the titanium plates were bent precisely,and the surgical reconstruction proceeded exactly as expected from the modeling process.Results All operations were achieved successfully.The extent of the lesion was coincident with the preoperative CT results,and the vascularized free fibular flaps were harvested and implanted into the defect regions accurately.The mean distance was (0.23 ±2.10) mm compared with the virtual fibula.The mean time of operation was 4.4 hours.Following up the mean 12.8 months,all patients obtained the excellent functional and cosmetic outcomes.Conclusion The procedure of operation was simplified and the time was shortened with reconstruction exactly using computer aided three-dimensional visualization technique,and the clinical therapeutic efficacy of reconstruction of mandibular defect with vascularized free fibular flaps was improved notably.

Objective:To study the association between the rs2013162 and rs2235375 polymorphisms in IRF6 and risk of NSCL/P in west Chinese population. Methods: The study group consisted of 332 NSCL/P patients, their parents (289 mothers, 243 fathers and 206 complete families), and 174 controls. PCR-RFLP method was used to identify genotypes and both case-parent and case-control designs were carried out on samples from west China. Results: There were significant differences in the frequency distributions of both genotypes and alleles when cases were compared with control infants at the rs2235375(P<0.01, P<0.01 respectively). We found strong evidence of over-transmission of the G allele at rs2235375 in cleft case-parent trios(P<0.01). Five specific haplotypes showed significant over-and under-transmission. Conclusion: These results suggest IRF6 variants play a role in NSCL/P in west Chinese populations.

Objective: To evaluate the clinical effects of CGF membrane for repairing the oral mucosa defects. Methods: 39 patients were selected with oral mucosa defects after surgical resections. 19 defects were covered by autologous CGF membranes as the experimental group. 20 defects were not covered by membrane as the control group. Regular follow-up were performed at one week, two weeks, three weeks, one month, two months, three months after the operations. And wound healings were compared in the groups. Results: CGF membranes of the 19 patients in the experimental group survived completely. And no infection occurred. The wound healing rate of the experimental group was higher than that of the control group at two weeks, three weeks and one month after the operations. And the difference was statistically significant(P<0.05). The VAS score of the experimental group was lower than that of the control group at one week, two weeks, three weeks and one month(P<0.05). The mean score of VSS score in the experimental group was lower than that in the control group (P<0.05). Conclusions Repair of the oral mucosa defects with CGF membrane can shorten the period of wound healing, relieve the postoperative discomfort and reduce the scar. It was a safe and effective method worthy to be popularized.

Objective To study effects of bivalirudin and heparin plus tirofiban on plasma P-selectin in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) and compare the clinical effects on bleeding and thrombosis.Methods 260 hospitalized patients with acute STEMI who accepted emergency PCI were enrolled in the study.They were randomly divided into the bivalirudin group (129 cases) and the heparin plus tirofiban group (131 cases).Blood samples were taken before operation,during operation (about 20 minutes after medicacion injection) and after operation (three hours after the end of operation).Serum P-selectin levels were measured.All patients were followed-up for 30 days.The main events included hemorrhage within 30 days,acquired thrombocytopenia and stent thrombosis.Results The level of P-selectin increased significantly in the heparin group during operation compared to the preoperative level and remained statistically higher at three hours after the end of operation than preoperative level (P ＜ 0.05).Compared with preoperative level,the P-selectin level of the bivalirudin group was significantly lower than that of heparin group (P ＜ 0.05).After 30 days of follow-up,bivalirudin had lower rates bleeding events compared to the heparin group(5.4％ vs.15.3％,P =0.009).The need of medical intervention for bleeding events (BRAC2-5 hemorrhage) was less in the bivalirudin group(0.8％ vs.5.3％,P =0.029).There was no significant difference in the major bleeding events between the 2 groups (BRAC3-5 hemorrhage) (0 vs.0.8％,P =0.32).No significant difference found between the two groups in acquired thrombocytopenia (P ＞ 0.05).Conclusion Bivalirudin may reduce P-selectin levels in STEMI patients undergone emergency PCI during perioperative period.Heparin increases perioperative P-selectin.Bivalirudin may reduce the bleeding events.

The postoperative evaluation of cleft lip is an important means to improve the operation method and the effect of the restoration. In recent years, the methods of cleft lip repair, such as Chinese western rotary propulsion, reconstruction of labial and nasal muscle tension band+trefoil flap, etc., have been developed. However, at present, there are still many secondary deformities, such as obvious scars and alar collapse. In this paper, in a review of the previous literature, the existing methods, advantages and disadvantages, and the application of the evaluation of the postoperative effect of cleft lip were reviewed. To date, there are many methods that can be used to evaluate the effect of cleft lip surgery. These research methods can be divided into subjective evaluation and objective evaluation, such as subjective evaluation, direct measurement, photo measurement, and three-dimensional scanning measurement. Among them, the subjective evaluation is simple, but the reliability is poor, and this method is suitable for all patients with cleft lip. The direct measurement has a low cost and is only suitable for one-dimensional information measurement, but the accuracy is poor, so it is difficult to determine the endpoints. The time of the photo measurement method is short, which can avoid tissue deformation, but it is easy to produce errors; this method is suitable for patients with cleft lip who can cooperate. The three-dimensional scanning measurement has a high accuracy, is time consuming and is a simple method but has a high cost and is suitable for areas with appropriate equipment conditions. Overall, the evaluation of the postoperative effect of cleft lip surgery should combine subjective evaluation with objective evaluation, dynamic evaluation with static evaluation, and utilize long-term follow-up to obtain comprehensive and accurate information and provide a reference for clinicians to carry out cleft lip surgery.

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

We reported a 54-year-old female patient with severe tricuspid regurgitation, who received mechanic valve in the mitral position 15 years ago. The patient’s Society of Thoracic Surgeons score was 8.27%, and was intolerant to open heart surgery, so she was recommended for transcatheter tricuspid valve replacement via right vena jugularis interna. The procedures were guided by echocardiography and X ray fluoroscopy on November 13, 2021, the prosthesis was implanted successfully, and the patient was recoved without any adverse events. After 1 month follow-up, her general condition was apparently improved.

Objective To analyze the clinical efficacy of transcatheter tricuspid valve replacement (TTVR) in cardiac implantable electronic lead-related tricuspid regurgitation (TR). Methods The patients with severe TR who underwent LuX-Valve TTVR in 9 Chinese medical centers from June 2020 to August 2021 were retrospectively enrolled. They were divided into a cardiac implantable electronic device (CIED) group and a non-CIED group based on whether they had pre-existing CIED implantation. Success of the procedure was defined as safe implantation of the LuX-Valve and complete withdrawal of the delivery system. Prognostic improvement was defined as a decrease of TR grade to≤2+ and an improvement of cardiac function by≥2 grades. Surgical success and postoperative prognosis were compared between the two groups. Results A total of 190 patients were collected, including 50 males and 140 females with a mean age of 66.2±7.8 years. There were 29 patients in the CIED group, and 161 patients in the non-CIED group. In the CIED group, 28 patients were implanted with a permanent pacemaker and 1 patient with a cardioverter-defibrillator. Preoperative New York Heart Association (NYHA) cardiac function class, TR degree, left ventricular ejection fraction, tricuspid annular plane systolic excusion, and cardiac risk scores were comparable between the two groups (P>0.05). Postoperative TR was reduced to≤2+ in all patients, and there was no statistical difference in the incidence of perivalvular leakage between the two groups (P=0.270). Postoperative CT of CIED patients showed the valve was in place, and the lead was not extruded, twisted, or deflected. The in-hospital mortality of the two groups were 10.3% and 1.9%, respectively, and the difference was statistically significant (P=0.047). In addition, there was no statistical difference between the two groups in terms of postoperative improvement of cardiac function and mortality in the 1- and 2-year follow-up. Conclusion TTVR is feasible, safe, and effective in patients with CIED implantation, and the pre-existing lead has no significant effect on the clinical efficacy.