Multiple trauma management requires the application of modem trauma care theories. Optimal treatment results can be achieved by reinforcing cooperation and stipulating a treatment plan together with other disciplines. Based on modem theories in trauma care and our understanding of the theoretical points, this paper analyzes the injury assessment strategies and methods in oral and maxillofacial multiple trauma management. Moreover, this paper discusses operating time and other influencing factors as well as proposed definitive surgical timing and indications in comprehensive management of oral and maxillofacial multiple trauma patients associated with injuries in other body parts. We hope that this paper can help stomatological physicians deepen their understanding of modem trauma care theories and improve their capacity and results in the treatment of oral and maxillofacial multiple trauma.
Humans ; Maxillofacial Injuries ; therapy ; Multiple Trauma ; Patient Care Planning ; Treatment Outcome

The report presents a case of epithelioid hemangioendothelioma in parotid gland misdiagnosed as parotid gland cyst with hemor-rhage.Based on the literature review,clinical characteristics,diagnosis and treatment of the disease are discussed.

Objective To evaluate the clinical effects of autogenous coronoid process reengineering condylar arthroplasty with simultaneous genioplasty for the correction of temporomandibular joint(TMJ)ankylosis accompanying micrognathia.Methods 21 cases of TMJ ankylosis with micrognathia from July 2003 to January 2012 were treated by autogenous coronoid process re-engineering condylar arthroplasty with simultaneous genioplasty.The follow-up period was 24 months to 8 years.TMJ function, mouth opening,occlusion,facial contour and the imaging manifestations were evaluated.Results After observation of follow-up,19 cases were improved obviously in the mandibular movement and mouth opening.Two cases had the recurrence of TMJ ankylosis. The facial appearance in all cases was significantly improved compared with before operation and the occlusal relationship had no large change compared with before operation.The coracoid process and mandibular ramus reached bone union with good reconstruc-tion by the panoramic radiographs.Compared with preoperation;the cephalometric results showed that the facial contour and process had statistical differences between postoperation and preoperation(P <0.05).Conclusion Autogenous coronoid process re-engineering condylar arthroplasty with simultaneous genioplasty can treat TMJ ankylosis accompanying micrognathia.

Receptor activity modifying proteins (RAMPs) is a kind protein with transmembrane functionality.RAMPs can interact with TypeⅡ G protein coupled receptors (GPCRs) such as calcitonin gene-related peptide receptor (CGRPR),calcitonin receptor (CTR) and calcitonin receptor-like receptor (CRLR),to form a stable heterodimer expression on the cell membrane.Different RAMPs can combine with CRLR or CTR to produce different receptor phenotypes with ligand-specific affinity and thus can decide biological effect of the receptors.In addition,RAMPs can also interact with other GPCRs,which promise broader application in function regulation of G-proteincoupled receptor of RAMPs'.RAMPs' regulation of GPCRs depends on its molecular basis.Our studies of RAMPs provides a new perspective to further researches on GPCRs functionality and CGRP signal transduction.

Objective To investigate the effects of rhBMP2 on the differentiation of human dental pulp stem cells and expression of Delta protein in vitro. provide a theoretical basis for research on human dental pulp stem cells. Methods Monocell suspension was separated from the human adult dental pulp with collagenase Ⅰ and dispase digestion.Clonogenic cells were observed under light microscope and the expressions of surface markers were determined with immunofluorescence. divided into experimental group (containing 50 ?g?L-1rhBMP2 in the culture medium) and negative control group (containing culture medium only).alkaline phosphatase and the expression of Delta proterin of the cells at at passage 5 were detected.Results The human dental pulp stem cells showed colony growth,the nestin and vimentin staining were positive by immunohistochemical staining.STRO-1 was positive in cells by immunofluorescence.Compared with negative control group, the activities of alkaline phosphatase increased after treatment with rhBMP2 for 7,14 and 21d(P

Objective:To elucidate the effects of calcitonin gene-re la ted peptide(CGRP) on the gene expression of osteoprotegerin(OPG) and receptor ac tivator of nuclear factor-?B ligand(RANKL) in rabbit osteoblasts. Meth ods:Osteoblasts were cultured in media containing 10 -10～10 -7 mol/L of CGRP. After 24-hour incubation,semi-quanitative RT-PCR was perfor med to detect the expression of OPG and RANKL mRNA,and with ?-actin mRNA as th e internal control. Results:CGRP increased the mRNA expressio n of OPG with the maximal effect at the concentration of 10 -8～10 -7 mol/L. CGPR downgulated the mRNA expression of RANKL dose-dependantly.C onclusion:CGRP may regulate the activities of osteoclasts by regulating gene expression of OPG/RANKL.

Objective To construct a bicistronic retrovirus expression vector to coexpress Delta1 and EGFP genes. Methods Delta1-IRES-EGFP bicistronic retrovirus vector was constructed by linking full-length Delta1 cDNA with IRES-EGFP retrovirus vector. Transfected with the retrovirus vector by electroporation, the ecotropic- and amphotropic-packaging cell lines GP+E86 and PA317 were selected by addition of puromycin. Positive cell clones were obtained and tested for the efficiency of the retroviral supernatants. Two positive cell clones with relatively highest titers were picked up and used for ping-pong amplification assay to improve the retroviral supernatants titer. At day 2 after transfection, GFP expression in NIH3T3 was detected by FACS, and Delta1 expression was determined by RT-PCR assay. Transfected or wild type NIH3T3 were co-cultured with myoblasts cell line C2C12 to test whether the exogenous Delta1 protein was functional or not. Results The bicistronic retrovirus expression vector coexpressing Delta1 and EGFP genes was successfully constructed and verified by PCR and DNA sequencing. A high-level expression of functional Delta protein was detected in transfected NIH3T3 cells. Conclusion Retrovirus is a safe, highly efficient gene transfer system.

Objective:To study the effect of sensory nerve on fracture of mandible and try to find the possible mechanism.Methods:Thirty-two China rabbits were used and divided into two groups for study.They all suffered from a standardized fracture in the left mandible,and half of them with inferior alveolar nerve section(IANS)or without.The callus were stained to observe the expression of substance P(SP)by immunochemistry and analysed by a computerized-graph analysing system.Results:Immunoreactivites of substance P occurred weakly on Day 7 and 14 after operation,and became stronger at late stage in IANS group.On the contrary,stronger immunoreactivites of substance P occurred at the early stage,less on day 21 posttrauma and stronger again on day 28 in control group.The strongest immunoreactivites at each stage occurred mainly in bone marrow on day 28 posttrauma in both groups.There was significant difference in the expressions of substance P in the callus between the two groups(P

The injurious changes of the microvasculature in the maxillofacial region due to high-velocity bullet injury were observed in different time intervals with scanning and transmission electron microscopy. It was found that there were microthrombus formation in the vascular lumen, and endothelial loss and dege-neration or necrosis of the vascular wall in the microvasulature around the wound. Our findings indicate that when early reconstructive surgery for the tissue defect due to gunshot wound especially for those in the maxillofacial region is to be performed with microsurgical technique, it is essential for the surgeon to realize and consider the wounding condition on the microvasculature of the recipient site.

Forty-five healthy male dogs were wounded with high or middle-velocity steel ball on the lower part of the face.and the findings were as follows:(1)Craniocerebral injuries concomitant with maxillofacial gunshot wounds were charcterized by brain contusion in the entry side of the temporal lobe and extradural hemorrhage in the entry side of the middle cranial fossa,and their highest incidence and severity were found in those cases with mandible fracture due to high-velocity missiles.(2)The larger the amount of the absorbed energy from the bullet,the higher the incidence and severity of the craniocerebral injury.(3)The incidence and severity of the craniocerebral injury were positively correlated to the value of vibrational acceleration measured on the pareital bones,which suggests that vibrational acceleration plays an important role in the precipitation of craniocerebral injury secondary to maxillofacial gunshot wounds.