砄bjective: To observe whether substance P(SP), calcitonin gene related peptide(CGRP), vasoactive intestinal polypeptide(VIP),? endorphin(? EP) are related to the pathogenesis of trigeminal neuralgia. Methods: During the attacks of trigeminal neuralgia, SP,CGRP,VIP,? EP in plasma from both external jugular and cubital fossa vein blood ipsilateral to the pain were assessed by sensitive radioimmunoassay in 16 ptients and 10 health controls, after operations the venous blood from the external jugular vein of the patients was sampled again; the external jugular vein blood of normal volunteers was collected as control. SP like and CGRP like immunoreactive positive granules of pain and painless branches were labelled using ABC immunohistochemistry methods; quantitative analysis was performed using HPIAS 1000 system. Results: During the attacks of trigeminal neuralgia, the levels of SP,CGRP,VIP in the external jugular vein blood were significantly higher than those in the cubital fossa vein blood, postoperative external jugular vein blood and the external jugular vein blood of normal volunteers. The plasma levels of ? EP in patients with trigeminal neuralgia were significantly lower than that in normal volunteers.The number and area of SP like ,CGRP like immunoreactive positive granules in the pain branches was much more and larger than those in the painless branches . Conclusion: Abnormal synthesis and release of neuropeptides in patients may be related to the pathogenesis of trigeminal neuralgia.

Objective:To study the role of tetrodotoxin-resistant(TTX-R)human sodium channel of hNa v1.8 mRNA in trigeminal neuralgia (TN). Methods:The samples of affected trigeminal division(inferior alveolar nerve) and non-affected division(lingual nerve) were surgically obtained from six idiopathic TN patients to whom the drug therapy was not effective.The expression of hNa v1.8 mRNA was assessed by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) with ?-actin as an internal control. A sample of great auricular nerve (from a patient who had to accept the combined radical neck dissection with glossectomy and hemimandibulectomy) and a sample of infraorbital nerve (from a patient who had to accept subtotal resection of maxilla) were used as the negative controls. Resoults:The relative amount of hNa v1.8 mRNA in the affected trigeminal divisions(1.233?0.324) was higher than that in the non-affected divisions(1.018?0.249), t=3.919,P=0.011. Conclusion:The higher expression of hNa v1.8 mRNA in the affected nerves of TN patients may play an important role in TN.

Objective: To summarize the experience of repairing or al and maxillofacial defects with radial forearm free flap. Methods: The clinical records of 110 cases received oral and maxillofacial reconstruction with radial forearm free flap were analyzed.Results: Forearm free flap healed well in 10 5 out of the 110 cases.with the overall success rate of 96.4%.Failure was in 4 c ases of cancer.One patient died from cerebral infarction 19 days after operation .Post operation infection did not result in the necrosis of the flaps because o f corresponding treatment in 5 cases.Conclusion: The radia l forearm free flap characterized by the anatomical consistency,easy fold, ideal thickness, flexibility and long pedicle, is feasible in the reconstruction of soft tissue defects in oral and maxillofacial region.

Standardized training program for residents in Shanghai is one of the important measures in the health care reform.In accordance with Implementary methods of standardized training for residents in shanghai (for trial implementation),the department of stomatology in the affiliated Changzheng Hospital quickly initialized the standardized training program by defining the training objectives,establishing the training mechanisms,formulating the training contents and building the system of the assessment.Special attention was paid to improve the professional skill of the residents including ① clinical diagnostic ability; ② medical theoretical level and the medical thinking ability; ③ interpersonal communicational skill; ④ professionalism; ⑤ scientific research ability.Useful exploration was made to test the feasibility of the training program based on the practices and the effect was encouraging.

Objective To investigate the intra-splenic blood cell count of posthepatitic cirrhotic portal hypertension,and compare it with patients' peripheral blood cell count to explore the role the spleen plays in peripheral cytopenia often seen in posthepatitic cirrhotic portal hypertension.Methods A prospective study was made on 15 cases with post hepatitis B cirrhotic portal hypertension undergoing splenectomy.Intrasplenic blood was sampled from upper pole,hilus (central pole),and lower pole of the spleen respectively for blood cell count.Results were compared with that of preoperative peripheral blood.Results There were significant statistical differences in the WBC count between splenic blood and peripheral blood,(11.20 ± 4.73) × 109/L vs.(4.06 ± 1.75) × 109/L,t =5.05,P ＜ 0.05),and in PLT count,(182.45±66.57) × 109/L vs.(63.54 ±28.40) × 109/L,t =7.285,P ＜0.05.There was no differences in the RBC count,(3.55 ± 0.94) × 1012/L vs.(3.01 ± 0.62) × 1012/L,t =1.874,P ＞ 0.05.Positive correlations were found between splenic PLT count and peripheral PLT count (r =0.610,P ＜0.05).Conclusions In posthepatitic B cirrhotic portal hypertension patients the intra-megalosplenic PLT and WBC count are significantly higher than that in peripheral blood.Megalosplenic PLT count correlates positively with peripheral PLT count.

Objective:To observe whether there is abnormal expression of tetrodotoxin-resistant (TTX-R)hNa v1.8 channel protein in demyelinated fibers of the affected nerves in patients with trigeminal neuralgia(TN), and to explore the relationship between ectopic discharges and TN.Methods: Six affected inferior alveolar nerves obtained from patients with idiopathic TN were studied. One great auricular nerve and one normal inferior alveolar nerve were used,which were obtained from patients undergoing combined radical neck dissection with glossectomy (negative control) and mandibulectomy (normal controls) . One rat spinal nerve was used as positive control. Immunohistochemical method and electron microscope were used to observe the expression of TTX-R hNa v1.8 channel protein in all groups. Results: Strong expression of hNa v1.8 channel protein was found in the demyelinated fibers of the affected nerves in patients with TN, weak expression in the neuraxon of rat spinal nerve,and none in the normal inferior alveolar nerve and the great auricular nerve. Conclusion: Abnormal expression of hNa v1.8 channel protein in the demyelinated fibers in patients with TN may play an important role in the pathogenesis of TN.

Objective: To study the effects of capsaicin applied locally to infraorbital nerve on primary afferent nerve inadult rats. Methods:Capsaicin solution (2% ) was directly applied onto one lateral intraorbital nerve, and the contralateralnerve was used as self-control. Both experimental and control infraorbita1 nerves were observed under electron tnicroscope on3, 7, 14, 21, 28, 35 or 42 d after local administration. Substance P(SP)--like immunoreactive positive granules in both lateralnucleus caudalis spinalis nervi trigemini (CNV) were examined by immunohistochemical method. Results: Degenerated un-myelinated fibers in capsaicin-treated nerves were found under electron microscope, and no myelinated fibers changes werefound. The gray scale value of SP-like immunoreactive positive granules in the experimental side was markedly lower thanthat in the control side (P＜0. 01), while no significant difference was observed between different time groups. Conclusion:Local administration of capsaicin can produce selective destruction of unmyelinated fibers in primary afferent nerves, and canreduce the levels of SP in regions of CNV. The results suggest that local administration of capsaicin has potential therapeuticvalue for trigeminal neuralgia.

To study the role of vein tubulation in the facial nerve regeneration. Methods:Twelve male adult SD rats were divided randomly into vein tubulation group,nerve graft group and normalcontrol group- The facial nerve trunks were cut and grafted' Three months p0stoperation, the distributionand variation of the fascicles were observed under light microscope. Fascicular area,axon number and axondensity were gauged and caculated. Results:Within the vein chamber, the regenerating nerve consisted ofmany fascicles. In the nerve graft, there was a major fascicle surrounded by many small fascicles. Thenormal facial nerve trunk had only one fascicle. Among 3 groups, the fascicular area and axon number ofthe nerve graft were largest, but the axon density had no significant difference. Conclusion: The micr0en-vironment in vein chamber may be beneficial to growth of regenerating axons.

OBJECTIVEThe aim of this study was to observe whether vasoactive intestinal polypeptide (VIP) participated in the attack of trigeminal neuralgia, and to understand further its pathogenetic mechanism.

METHODSSixteen patients were studied. During the attacks the venous blood was sampled from both the external jugular vein and cubital fossa vein ipsilateral to the pain, and after operations the venous blood from the external jugular vein was sampled again, the external jugular vein blood of eleven normal volunteers was collected as the control. Plasma levels of VIP were determined using sensitive radioimmunoassays.

RESULTSDuring the attacks of trigeminal neuralgia the levels of VIP in the external jugular vein blood were significantly higher than that in the cubital fossa vein blood, postoperative external jugular vein blood and the external jugular vein blood of normal volunteers.

CONCLUSIONVIP indeed participates in the attack of trigeminal neuralgia in the local region, the role of VIP may be relating to enhancing the effects of substance P in local neurogenic inflammation.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Radioimmunoassay ; Substance P ; metabolism ; Trigeminal Neuralgia ; blood ; Vasoactive Intestinal Peptide ; blood

Objective To evaluate the clinical feature of malignant ameloblastoma. Methods A review of 25 cases of malignant ameloblastoma was presented with respect to age, sex, primary site and times of recurrence, site and time of metastasis, results of follow up, pathological type. Results Male patients outnumbered female patients by 1.5 to1. The median age at which the primary tumor was first treated was 30.5 years. The primary sites were mandible(17), maxilla(5), tibia(1), rib(1), ulna(1). The most metastases were found in lung(80%), with cervical lymph nodes and liver each representing 24% and 12% of the metastatic sites. Other sites of metastasis included brain(1), femur(1), thoracic spine(1), spleen(1), myocardial(1), mediastinum(1). The median times of primary recurrence was 2.5 times. The median survival time after metastasis was 2 years. There were four pathological types which were follicular type(4), plexiform type(2), acanthomatous type(1), granular type(1). Conclusins Multiple recurrences developed in most of the 25 patients. The time between diagnosis of primary tumor and appearance of metastasis in 25 patients was long. The most frequent sites of metastasis was lung and cervical lymph nodes. Early adequate resection of the primary tumor to avoid repeated surgical intervention is advocated to prevent tumor spread.