Objective To study clinical effect of transplantation with vascularized ilium bone and free fibulae, and internal fixation of titanium plate on reconstruction of maxillary defect. Methods Nine cases of maxillary defect were repaired by 7 iliac muscle flaps with deep circumflex iliac artery and vein, 2 cases of fibulae muscle flap with peroneal artery and vein, meanwhile, fixed internally by titanium plate. The vessels were anastomosed with arteria and vena maxillaries externa. Results Nine patients were confirmed by 99m TcMDP 2-4 weeks after operation that the supply of blood was well and the graft bones were survival. By follow-up from 6 months to 3 years after operation, the fixations of graft bones were good. Conclusion Vascularized bone graft and internal fixation of titanium plate is one of the best ways for reconstruction of maxillary defect.

OBJECTIVEA study was conducted to investigate the relevant applied technique and clinical value of endoscope-assisted repair of zygomatic arch fracture.

METHODSA total of 10 cases of unilateral zygomatic arch fracture and 8 cases ofunilateral zygomatic fracture were included. Reduction and fixation of the zygomatic arch in all cases were performed via asmall face incision by an endoscope. Endoscope-assisted repair allowed exposure of zygomatic arch fracture and ended the anatomy of the reset. Zygomatic arch was stabilized with titanium plates.

RESULTSSymmetric malar was achieved in allcases after operation. Patients did not show difficulty in opening the mouth. No chewing problems or severe complicationswere evident. This method had the advantage of hidden incision, and it did not leave scars on the face. Postoperative CT examination showed excellent reduction of zygomatic arch fracture and good fixed position of titanium plate.

CONCLUSIONEndoscope-assisted repair of zygomatic arch fracture via a small face incision can be an alternative operation for zygomaticarch fracture. Patients are less traumatized. There are fewer complications. A good reduction of fracture is achieved.

Bone Plates ; Endoscopes ; Endoscopy ; methods ; Facial Bones ; Fracture Fixation, Internal ; methods ; Fractures, Closed ; surgery ; Humans ; Titanium ; Tomography, X-Ray Computed ; Treatment Outcome ; Wound Healing ; Zygoma ; injuries ; Zygomatic Fractures ; diagnostic imaging ; surgery

Objective To investigate the quality of life of nurses group in Shenzhen city and explore its influencing factors, so as to provide evidence for health policy making health promotion and science research. Methods Self-designed questionnaires were used in social demography survey and SF-36 was adopted to survey 495 in-service nurses on front line from four hospitals in Shenzhen. Paired samples t Test and multivariable stepwise regression were carried out to analyze the quality of life among nurses in Shenzhen city and general population in China. Results The data showed the scores of the physiological domain, psychological domain and quality of life nurses in Shenzhen city and Chinese general population was (68.60±17.61), (69.91±17.91), (67.29±20.29)and (78.18± 15.88), (79.36±17.00), (77.00± 17.42), respectively. The difference had statistical significance. Multivariable stepwise regression showed that quality of life was positively correlated with APN scheduling, education, department, monthly income, working range, age and the hospital level in descending sort Conclusions Health authorities, hospital leaders and nurses-selves should pay more attention to the quality of life for nurses group and take positive mea-sures to improve quality of life of nurses group.

Objective To recommend the safety guidelines for workplace violence on health care sector according to the incidents of violence status on medical workplace.Methods A pilot study was conducted using a two-round Delphi method to study out the safety guidelines for hospital violence.Results In two subsequent rounds,the group discussed and screened out 50 entries from 51 items in the six modules as safety guidelines for hospital violence.Conclusions Establishment of safety guidelines for hospital violence on health care sector using Delphi method requires further clinical validation.

OBJECTIVETo evaluate the effective of transconjunctival approach in treating orbitozygomatic complex fractures.

METHODSFifty-four transconjunctival incisions were applied to correct enophthalmos and face collapse in 46 patients who suffered by orbitozygomatic complex fractures. All operative procedures were performed with an additional lateral canthotomy (5-10 mm) and 43 of them with gingivobuccal sulcus incisions simultaneously. The infraorbital rim and lateral orbital wall were stabilized with titanium plates. Titanium nets were used to reconstruct the comminuted orbit floor fractures.

RESULTSThe bilateral zygomaticas of 46 cases with orbitozygomatic complex fractures were basically symmetric, and the eyeball positions were reset anatomically. The treatment effectiveness were satisfactory. There were no obvious postoperative complications, except one corneal epithelium stripped on the right side and one overtime swelling of conjunctiva which cured after relevant treatments.

CONCLUSIONThe transconjunctival approach has good exposure to the orbital floor without visible scar and injury to facial nerve branches, it is a preferable procedure to reconstruct orbitozygomatic fractures.

Conjunctiva ; Humans ; Orbital Fractures ; Postoperative Complications ; Reconstructive Surgical Procedures ; Treatment Outcome

Objective To investigate the effect of signal characteristics of MR T2WI for predicting HIFU treatment outcome for adenomyosis.Methods According to signal characteristics of MR T2WI before HIFU treatment,502 adenomyosis patients were divided into group Ⅰ (lesions with most hypointense and/or little isointense) and group Ⅱ (lesions with most isointense and/or little hypointense).Then patients in each group were further subdivided into subgroup A (without slightly and extremely hyperintense foci in the lesions),subgroup B (with slightly hyperintense foci in the lesions) or subgroup C (with extremely and/or slightly hyperintense foci in the lesions).The correlation of signal characteristics of MR T2WI for adenomyosis on HIFU ablation results and parameters were analyzed.Results There was no statistical difference of non-perfused volume ratio (NPVR) between group Ⅰ and group Ⅱ (t=-0.504,P=0.612).In both group Ⅰ and group Ⅱ,NPVR of subgroup A was higher than that of subgroup B and subgroup C,respectively (group Ⅰ:LSD-t=2.608,3.677,P=0.009,＜0.001;group Ⅱ:LSD-t=3.255,3.778,P=0.001,＜0.001).There was no statistical difference of NPVR between subgroup B and subgroup C (group Ⅰ:LSD-t=-0.852,P=0.395;group Ⅱ:LSD-t=0.278,P=0.781).There was no statistical difference of sonication time,total ablation energy and energyefficiency factor (EEF) between group Ⅰ and group Ⅱ,respectively (sonication time:t=-1.716,P=0.087;total ablation energy:t=-1.676,P=0.094;EEF:Z=0.044,P=0.965).In both group Ⅰ and group Ⅱ,sonicationtime,total ablation energy and EEF of subgroup A were lower than those of subgroup B and subgroup C (all P＜0.05),while no statistical difference was found between subgroup B and subgroup C (all P＞0.05).Conclusion Signal characteristics of adenomyosis on MR T2WI can be used as predictors of HIFU treatment outcome for adenomyosis.