Objective To study the operation design and surgical methods for terminal surgical reconstruction of severe post-midfacial fracture deformities. Methods From July 1997 to December 2002,11 cases of severe and complex post-midfacial deformities were reconstructed. There were four cases with Le Fort Ⅰ, Ⅱ and Ⅲ fractures,five with Le Fort Ⅰ and Ⅲ fractures and two with Le Fort Ⅰ and Ⅱ fractures combined with right orbital-zygomatic fractures. Typical bicoronal and subcilliary incisions and intra-oral approach were employed to expose all the fractured sites. The displaced orbito-zygomatic bone fragments were repositioned firstly in order to reconstruct the outer midfacial framework. Then, the malunited maxilla was reduced to its proper position after osteotomy of Le Fort Ⅰ fractures under the guidance of mandible through inter-maxilla fixation. The depressed naso-orbital region were reconstructed using autogeneous outer cranial table. Meanwhile, nasal framework reconstruction, medial canthal tendon reapproximation and plasty, and fractured orbital walls repairing were performed to correct the enophathalmos. Results All the cases recovered well and the post-operative facial appearance and occlusal function were improved obviously. Conclusions Complex midfacial fractures, usually involving orbital-zygomatic bone, naso-orbit and maxillary bone, can be well improved through osteotomy and reduction, internal rigid fixation with mini-plates and screws, autogenenous bone grafting and framework reconstruction.

OBJECTIVETo compare the early clinical effects of Activ C cervical disc replacement (ACDR) and anterior cervical discectomy and fusion (ACDF) in treating single-level cervical spondylosis.

METHODSThe clinical data of 76 patients with single-level cervical spondylosis underwent surgery from July 2009 to September 2012 were retrospectively analyzed. Among them, 28 patients were treated with ACDR (ACDR group), including 18 males and 10 females, aged from 32 to 62 years old with an average of (45.2±6.2) years; and 48 patients were treated with ACDF (ACDF group), including 28 males and 20 females, aged from 33 to 60 years old with an average of (45.8±6.4) years. Visual analogue scale (VAS), Japanese Orthopedics Association (JOA) score, Short Form-36 (SF-36), imaging data were used to assess the clinical effects after operation.

RESULTSA total of 76 patients were followed up from 6 to 24 months with an average of 13.2 months. VAS of neck pain and brachialgia were improved in all patients after operation (P<0.05), there was no significant difference between two group (P>0.05). Somato-score and psycho-score of SF-36 of two groups were obviously increased (P<0.05), ACDR group was better than that of ACDF group (P<0.05). In ACDR group, there was no significant difference in the range of motion of surgical segments and adjacent segments between preoperative and postoperative (P>0.05); heterotopic ossification around the edge of vertebral body occurred in 1 case on the 6th month after operation, no fusion was found on the 1st year after operation. In ACDF group, the adjacent vertebral disease occurred in 1 case and the patient underwent the reoperation.

CONCLUSIONActiv C cervical disc replacement can reduce the degeneration of adjacent segments and its early outcomes for the treatment of single-level cervical spondylosis are satisfactory, but the long-term effects still need study.

Adult ; Cervical Vertebrae ; surgery ; Diskectomy ; methods ; Female ; Humans ; Male ; Middle Aged ; Spinal Fusion ; methods ; Spondylosis ; surgery ; Total Disc Replacement ; methods

Objective:To explore the influence of ischemia/reperfusion (anoxia/reoxygenation)[FK(W16*2。142mmZQ1mm]on immunofunction of endothelial cells(ECs) and effect of intervention with 2-hydroxymethyl-3,5,6-trimethylpyrazine on it.Methods:Model of ECs induced by anoxia/reoxygenation was established to mimic ECs ischemia/reperfusion injury in vivo with human umbilical vein endothelial cell line ECV304.Then 2-hydroxymethyl-3,5,6-trimethylpyraxine was used to intervene the anoxia/reoxygenation process.Nuclear transcriptional factor-?B(NF-?B) was exhibited by fluorescent staining,HLA-ABC,HLA-DR,CD86 and CD54 were detected by flow cytometry.Mixed endothelial cell-lymphocyte reaction(MELR) was conducted to examine the proliferation of lymphocyte,production of IL-2 and percentage of apoptotic lymphocyte.Results:Anoxia/reoxygenation made the ECV304 cell became round,shrunk and abscised,with increased plasma NF-?B,and changed from positive cytoplasm to positive nucleus.HLA-ABC,HLA-DR and CD86 on surface of cells increased but CD54 showed unchanged.MELR showed the incorporation of ~3H-TdR and production of IL-2 increased significantly and the percentage of apoptotic lymphocyte decreased.After 2-hydroxymethyl-3,5,6-trimethylpyrazine intervention,the ECV304 cell shapes recovered,NF-?B expression didn’t down-regulated,but the percentage of positive cells decreased,changes to positve dominant.Besides,reversal changes were shown in other parameters.Conclusion:Anoxia/reoxygenation influences some important immune related molecules in ECV304 cells.2-hydroxymethyl-3,5,6-trimethylpyrazine could antagonize these influences to maintain the immune function of endothelial cells in a relative normal manner.

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy combined with limited open repair of medial collateral ligament (MCL) for the treatment of multiple ligament injuries of knee joints.

METHODSFrom March 2006 and June 2012,the data of 14 patients (14 knees) with multiple injuries of ACL, PCL, and MCL were collected. There were 8 males and 6 females with an average age of (31.8 +/- 8.1) years old (ranged, 20 to 49 years old). All the patients were performed with X-ray and MRI examination, and the results showed that 10 patients had combined with injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL); 4 patients had ALC,PCL and posterolateral corner (PLC) injuries. Four patients had medial meniscus injuries and 2 patients had lateral meniscus injuries. The MCL,PLC and meniscus injuries were treated with operation on the first stage, and functional exercises were performed 3 weeks after fixation. The reconstruction operation of ACL and (or) PCL was performed at the second stage under arthroscopy 3 to 6 months later when the movement range of knee joint recovered to the normal level with obvious relaxation.

RESULTSAll incisions healed by primary intention. All the patients were followed up with a mean duration of 48.9 months (ranged, 24 to 80 months). The Lysholm score was improved from preoperative 19.6 +/- 0.9 to the latest follow-up 87.1 +/- 2.8 (t=12.3, P<0.01). The International Knee Documentation Committee (IKDC) rating: 9 cases nearly recovered to normal, 5 cases were abnormal.

CONCLUSIONFor multiple ligament injuries in the knee, staged repair and reconstruction can effectively restore knee joint stability and function.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; physiopathology ; surgery ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective To discuss the curative effect of transplantation using donation after cardiac death (DCD) according with Chinese standard Ⅲ (C-Ⅲ).Methods The organs were obtained from 4 DCDs from 2011 to 2012,and the clinical data of DCD transplantation were retrospectively analyzed.Withdrawal of life support occurred in the operating room.Donor warm ischemia time was 7-15 min.Results The biopsy of liver was performed on the 3rd DCD.Eight cases were subjected to renal transplantations,and 3 to liver transplantations.One patient exhibited delayed graft function of the kidney from the 4th DCD.All patients made an uneventful recovery and were discharged from the hospital without rejection or surgical complication.They were followed up in outpatient department.Conclusion The use of DCD according with C-Ⅲ is an effective way to increase the number of organs available for transplantation,and can obtain satisfactory effects.

OBJECTIVETo study the effects of Bu Yang Huan Wu Decoction on astrocytes after cerebral ischemia and reperfusion.

METHODCerebral ischemia model in gerbils was produced by ligating bilateral common carotid artery. The dynamic expressin of GFAP were determined by immunochemistry after cerebyal ischemia for 15 min followed by reperfusion for 24 hours and 48 hours.

RESULTGFAP positive reactions reached a peak after cerebral ischemia for 15 min followed by reperfusion for 24 hours. Bu Yang Huan Wu Decoction decreased the expression. GFAP positive reactions decreased after cerebral ischemia for 15 min followed by reperfusion for 48 hours, Bu Yang Huan Wu Decoction increased the expression.

CONCLUSIONThe regulation of Bu Yang Huan Wu Decoction on astrocytes after cerebral ischemia and reperfusion may be related to repairing process after cerebral ischemia.

Animals ; Astrocytes ; drug effects ; Brain Ischemia ; complications ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Female ; Glial Fibrillary Acidic Protein ; metabolism ; Hippocampus ; metabolism ; Male ; Plants, Medicinal ; chemistry ; Reperfusion Injury ; etiology ; metabolism ; pathology

OBJECTIVETo study the expression of livin at the invasive tumor front of oral squamous cell carcinoma.

METHODSForty-eight samples of oral squamous cell carcinoma were graded according to invasive front gading (IFG). The expression of livin was evaluated at the ITF and other parts of the same tumor using immunohistochemistry.

RESULTSSignificant difference in the pathological grades was found between the ITF and the other parts of oral squamous cell carcinoma (P<0.01). The expression of livin at the ITF was significantly stronger than that in the other regions (P<0.01). A significant positive correlation was noted between livin expression and the TFG score (P<0.05).

CONCLUSIONInhibition of cell apoptosis is more obvious at the ITF of oral squamous cell carcinoma than in the other regions. Livin overexpression at the ITF may indicate greater malignancy and higher likeliness of tumor recurrence and metastasis.

Adaptor Proteins, Signal Transducing ; genetics ; metabolism ; Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; genetics ; metabolism ; Male ; Middle Aged ; Mouth Neoplasms ; metabolism ; pathology ; Neoplasm Invasiveness ; Neoplasm Proteins ; genetics ; metabolism

OBJECTIVETo analyze the clinical results and complications of three methods for microgenia, including chin augmentation with silicone implant, bone autograft, and genioplasty.

METHODSThe advantages and disadvantages of the three methods for microgenia were assessed through 3-D CT reconstruction, X-ray and intraoperative observation during the second operation. The indications for each technique were also studied.

RESULTSThe frequently observed problems for chin augmentation with silicone implants were implant malposition, underlying bone absorption, periosteal reaction and undercorrection. Chin augmentation with bone autograft had a great long-term bone graft absorption which led to undercorrection. Genioplasty showed a satisfactory cosmetic result with no serious complication.

CONCLUSIONSChin augmentation with silicone implant is suitable for mild microgenia with a shallow mentolabial groove, but without facial vertical insufficient and facial asymmetry. Genioplasty can be used in all kinds of microgenia in any severity, especially those with deviated chin and facial asymmetry. Chin augmentation with bone autograft can't achieve good long-term result and should be applied prudently.

Adult ; Chin ; abnormalities ; surgery ; Female ; Humans ; Prostheses and Implants ; Silicone Elastomers ; Surgery, Plastic ; methods ; Young Adult

This study was aimed to investigate the effect of valproic acid (VPA), a histone deacetylase inhibitor, on angiogenesis of acute myeloid leukemia in vivo and vitro, and to explore its molecular mechanism. Human t (8;21) AML cell line Kasumi-1 cells were treated with VPA at different concentration for 3 d, the mRNA and protein expression levels of Ang1 and Ang2 were determined by semi-quantitative RT-PCR and Western blot respectively. Nude mice model with xenograft Kasumi-1 tumor was established by subcutaneous inoculation of Kasumi-1 cells. The CD34, Ang1 and Ang2 protein levels were analyzed by immunohistochemistry method. The mRNA and protein expression levels of Ang1, Ang2 and VEGF were determined by semi-quantitative RT-PCR and Western blot. The results showed that in vitro, VPA at 3 mmol/L downregulated the Ang mRNA relative expression level for Ang1 from 0.360 ± 0.116 to 0.040 ± 0.008, Ang2 from 0.540 ± 0.049 to 0.146 ± 0.038. The animal experiment further verified that VPA 500 mg/kg, ip, for 14 d, reduced the relative expression of Ang1, Ang2 and VEGF mRNA and proteins in Kasumi-1 tumor of nude mice, and reduced microvascular density in xenograft tumor of nude mice (8.470 ± 0.300 vs 2.600 ± 0.200). It is concluded that VPA significantly inhibits tumor angiogenesis through the regulation of angiopoietins, thereby inhibits the proliferation and metastasis of leukemia cells.
Angiopoietins ; metabolism ; Animals ; Antigens, CD34 ; metabolism ; Cell Line, Tumor ; Female ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neovascularization, Pathologic ; metabolism ; RNA, Messenger ; genetics ; Valproic Acid ; pharmacology ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays

OBJECTIVETo investigate the changes of mandibular vitodynamics in powerful bite working condition and impact working condition after mandibular angle osteotomy through 3-dimensional finit element analysis.

METHODSA patient of prominent mandibualr angle without malocclusion was selected and underwent 3-dimensional CT before and after operation. The DICOM data of 3-dimensional CT were read by Mimics software and 3-dimensional images were reconstructed. Then the 3-dimensional images were changed into IGES format and imported into ANSYS10.0. The boundary constrained condition and pre-processing condition was setting in ANSYS10.0 software. The 3-dimensional finite element models were generated in ANSYS10.0. Solution process was running and most powerful bite working condition and impact working condition were simulated and calculated.

RESULTSIn static stress analysis, the stress peak and stress maximal value point of mandible were basically at equal pace in preoperative and postoperative models. In transience dynamic stress analysis, although stress discrepancies were found in part time point and some region of mandible between preoperative model and postoperative model, the direction and topography of main stress were basically at equal pace. Main stress distributed beside external oblique line and concentrates at the neck of condyle. There was no significant difference of stress conduction and distribution between preoperative and postoperative models.

CONCLUSIONSCompared with preoperative model, postoperative model has different transduction phases of stress, but has almost the same tolerance extents of main stress.

Female ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Mandible ; physiopathology ; surgery ; Osteotomy ; Stress, Mechanical