Oral and maxillofacial surgery is one kind of special subjects involving multiple clinical disciplines.The postgraduate training is different from other professional postgraduate training model,which emphasizes the cultivation of students,should be first medical students,then dentist.In new situation,we advance the experiences in exploring how to cultivate high quality postgraduate of oral and maxillofacial surgery.

AIM To study the chemical constituents from twigs of Trigonostemon lutescens Y.T.Chang et J.Y.Liang.METHODS The ethyl acetate fraction of 95％ ethanol extract from T.lutescens twigs was isolated and purified by silica,Sephadex LH-20 and MCI column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and elucidated as 3-O-acetyloleanolic acid (1),methyl 3-acetoxy-12-enly-oleanen-28-oate (2),taraxerone (3),spiciflorin (4),simiarenol (5),β-sitosterol palmitate (6),3,3',4-tri-O-methylellagic acid (7),β-sitosterol (8),stigamasterol (9),palmitic acid (10).CONCLUSION Compounds 1-6 are isolated from genus Trigonostemon for the first time,compounds 7 and 9 are first obtained from this plant.

Objective:To study the lethal effect of vitamin C carbon dots on oral squamous cell carcinoma KB cells, and to clarity its related mechanism.Methods: The KB cells were treated with different concentrations (5, 10, 20, 40 and 80 mg·L-1) of vitamin C carbon dots in vitro as experimental groups, and 0 mg·L-1 vitamin C carbon dots group was used as blank control group.MTT assay was used to detect the proliferation rates of KB cells in various groups;colony formation assay was used to detect the colony formation ability of KB cells;Western blotting was performed to detect the protein expression levels of autophagy related protein LC3 in KB cells in various groups;flow cytometry was used to detect the apoptotic rates of KB cells in various groups.Results: Compared with blank control group, the proliferation rates and colony formation abilities of KB cells in 20, 40 and 80 mg·L-1 carbon dots groups were markedly decreased (P<0.01).Compared with blank control group, the protein expression level of LC3 Ⅱ in 40 mg·L-1 carbon dots group was increased(P<0.05);the apoptotic rate of KB cells was markedly increased(P<0.01).Conclusion: Vitamin C carbon dots can kill the oral squamous cell carcinoma KB cells effectively, suppress the proliferation and impair the colony formation ability of KB cells, which is related to autophagy and apoptosis of KB cells.

Objective:To develop and evaluate the improved Chinese hearing questionnaire for school children(CHQS)for mass epidemiology study on hearing impairment in China.Method:Using the probability proportion to size(PPS) method, 8 412 residents were investigated in 40 clusters in Jiangsu province with the WHO ear diseases and hearing disorders survey protocol.87.9% of the residents aged 7 years and over answered the questionnaire and accepted the pure tone audiometry.Result:The prevalence of hearing impairment was 12.9% by the questionnaire. Compared with golden standard(pure tone audiometry), Sen=58.5%, Spe=96.7%, PV+=78.9%, PV-=91.7%, overall accuracy=90.0% . The sensitivity for women was higher than men.Conclusion:The questionnaire produced high efficiency and specificity values.It could be used in mass hearing screening, particularly in remote and rural area, although the sensitivity was as low as most questionnaires.

OBJECTIVETo investigate the clinical effects of treatment for superior tibial fracture complicating with crotch injury of distal popliteal artery by an alternative micro-surgical operation.

METHODSDuring Feb. 2002 to Oct. 2007, there were 19 patients with superior tibial fracture complicating with crotch injury of distal popliteal artery included 15 males and 4 females aged from 21 to 48 years (means 35 years). There were 6 cases complicating with fracture of tibial plateau, 3 cases complicating with nerve injury. The tibial fracture were fixed with external fixator and the anterior tibial artery and vein and posterior tibial artery and vein were treated by transplantable great saphenous vein (Y-shape) combined with windowing for interosseous membrane by the posterior and anterolateral incision. Evaluations of clinical effect were performed according to Rasmussen functional score system.

RESULTSAll patients survived after operation. All fracture achieved bony union, the union time was from 3 to 14 months (means 5.5 months). All patients were followed-up for from 8 to 23 months (means 13 months). The mean Rasmussen functional score was (27.0 + 2.9). The results were excellent in 11 cases, good in 7, and fair in 1.

CONCLUSIONThe surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries is definite or highly suspected. Simultaneous reconstruction of both posterior tibial artery and anterior tibial artery associated with vein can reduce the rate of disability and recover function of limb.

Adult ; Female ; Follow-Up Studies ; Groin ; blood supply ; surgery ; Humans ; Male ; Microsurgery ; Middle Aged ; Popliteal Artery ; injuries ; surgery ; Reconstructive Surgical Procedures ; Tibial Fractures ; complications ; diagnosis ; therapy ; Young Adult

Adult ; Antigens, CD20 ; metabolism ; Cervical Vertebrae ; pathology ; Eosinophilic Granuloma ; complications ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Hodgkin Disease ; complications ; metabolism ; pathology ; surgery ; Humans ; Ki-1 Antigen ; metabolism ; Male ; Middle Aged ; Spinal Neoplasms ; complications ; metabolism ; pathology ; surgery ; Thoracic Vertebrae ; pathology

OBJECTIVETo explore the etiology, clinical aspects, diagnosis and therapeutic strategies of acute low-tone sensorineural hearing loss (ALHL).

METHODSThirty patients (31 ears) with ALHL were selected for this study. Detailed history collection, otological examination and systematic audiological evaluations were conducted. The hearing tests included pure tone audiometry, acoustic immittance, auditory brainstem response (ABR) and otoacoustic emissions (OAE). All cases received therapeutic trial of corticosteroid for 15 days with 6 to 14 months' following-up.

RESULTSALHL mainly affected young people. Low-tone tinnitus, a sensation of ear fullness and hearing impairment were the frequent complains. Otological examinations showed normal results. Mild to moderate sensorineural hearing loss at low frequencies and type "A" tympanograms were found in all patients. Acoustic stapedial reflexes were elicited in 26 of 31 affected ears, and 14 of them had positive results on the Metz test. ABR responses were normal in all 20 tested ears. In 14 out of 20 ears, TEOAEs were absent and DPOAE grams at low frequencies (0.5, 0.75 kHz) were abnormal on the first visit. After steroid therapy, 24 ears demonstrated complete recovery, but 4 ears showed partial recovery and 3 ears unchanged. The total improvement rate was 90.3%.

CONCLUSIONSALHL patients are clinically characterized by low-tone tinnitus, aural fullness and hearing loss, which mainly involved unilateral ear. Audiological findings indicate a cochlear impairment, which only invades low frequency region. The basic pathological feature may be endolymphatic hydrops involves immune response. Conflicting data exist on whether ALHL is an independent disorder or a subtype of Meniere's disease. Ideal therapeutic strategy has not been established by now and corticosteroid is probably an effective agent.

Acute Disease ; Adrenal Cortex Hormones ; therapeutic use ; Adult ; Audiometry, Evoked Response ; Endolymphatic Hydrops ; etiology ; Female ; Hearing Loss, Sensorineural ; diagnosis ; drug therapy ; physiopathology ; Humans ; Male ; Meniere Disease ; diagnosis ; drug therapy ; physiopathology ; Middle Aged ; Otoacoustic Emissions, Spontaneous

OBJECTIVE: To investigate incidents and clinical features of auditory neuropathy in Nanjing deaf school students. METHOD: Three hundred and fifty-eight deaf students in the school accepted the first examination including otoscopic examination, tympanometry and transiently evoked otoacoustic emissions (TEOAE) screening. Detailed audiological and vestibular evaluations including pure-tone audiometry, immittance audiometry and acoustic reflex measures, transiently evoked otoacoustic emissions (TEOAE), distortion product otoacoustic emissions (DPOAE), auditory brain stem response (ABR), electronystagmography (ENG) and vestibular evoked myogenic potential (VEMP) were given to whom had positive TEOAE screening. RESULT: Three hundred and twenty-three students entered the program of screening for auditory neuropathy. One student had positive TEOAE in single ear while the other two had positive TEOAE in both ears. In the screening stage,there were strong evidences in these three students with auditory neuropathy in the detailed audiological procedures. CONCLUSION Auditory neuropathy, which can also be found in deaf schools, is not as rare as we thought before. Early identification and intervention may help those children to avoid entering the deaf school and to return to normal society.
Adolescent ; Adult ; Audiometry, Pure-Tone ; Child ; China ; epidemiology ; Cochlear Microphonic Potentials ; Deafness ; epidemiology ; physiopathology ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss, Central ; epidemiology ; physiopathology ; Humans ; Male ; Otoacoustic Emissions, Spontaneous ; Students ; Young Adult

Objective To evaluate the effect of ultrasound-guided erector spinae plane block combined with general anesthesia on early postoperative outcome in patients undergoing video-assisted thoracoscopic pulmonary lobectomy.Methods Eighty-five patients of both sexes,aged 18-64 yr,with body mass index of 18-24 kg/m2,of American Society Anesthesiologists physical status Ⅱ or Ⅲ,undergoing elective video-assisted thoracoscopic pulmonary lobectomy,were divided into 2 groups using a random number table method:general anesthesia group (group GA,n =43) and ultrasound-guided erector spinae plane block combined with general anesthesia group (group ESP+GA,n =42).Ultrasound-guided erector spinae plane block was performed after induction of general anesthesia,0.5％ ropivacaine 20 ml was injected in group ESP+GA,and 0.9％ normal saline 20 ml was injected in group GA.Both groups received patient-controlled intravenous analgesia with sufentanil after surgery.Tramadol was intramuscularly injcted as resue analgesic when visual analog scale score＞3.Quality of Recovery-40 questionnaire was used to assess the early postoperative quality of recovery at 1 day before surgery and 1 and 2 days after surgery.The consumption of intraoperative remifentanil and postoperative sufentanil,requirement for rescue analgesics and occurrence of postoperative adverse reactions were recorded.Results Compared with group GA,the Quality of Recovery-40 questionnaire scores were significantly increased at 1 and 2 days after surgery,the consumption of intraoperative remifentanil and postoperative sufentanil was reduced,and the requirement for rescue analgesics and incidence of nausea and vomiting were decreased in group ESP+GA (P＜0.05).Conclusion Ultrasoundguided erector spinae plane block combined with general anesthesia can promote early postoperative outcome in patients undergoing video-assisted thoracoscopic pulmonary lobectomy.

OBJECTIVE: To develop and evaluate the improved Chinese hearing questionnaire for school children (CHQS) for mass epidemiology study on hearing impairment in China. METHOD: Using the probability proportion to size (PPS) method, 8412 residents were investigated in 40 clusters in Jiangsu province with the WHO ear diseases and hearing disorders survey protocol. 87.9% of the residents aged 7 years and over answered the questionnaire and accepted the pure tone audiometry. RESULT: The prevalence of hearing impairment was 12.9% by the questionnaire. Compared with "golden standard" (pure tone audiometry), Sen = 58.5%, Spe = 96.7%, PV+ = 78.9%, PV- = 91.7%, overall accuracy = 90.0%. The sensitivity for women was higher than men. CONCLUSION The questionnaire produced high efficiency and specificity values. It could be used in mass hearing screening, particularly in remote and rural area, although the sensitivity was as low as most questionnaires.
China ; epidemiology ; Female ; Hearing Disorders ; epidemiology ; prevention & control ; Humans ; Male ; Sensitivity and Specificity ; Surveys and Questionnaires