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 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

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.

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 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

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 determine ITI implants stability in different bone types using RFA and to provide evidence for feasibility of early loading.

METHODSA total of 104 ITI sand-blasted large-grit acid-etched (SLA) implants in 50 patients were classified into 3 groups according to bone type. Resonance frequency analysis was conducted at 0, 1, 4, 6, 8 and 12 weeks after installation.

RESULTSThe survival rate was 100%. Primary stability was affected by bone type (P < 0.001). The implant stability quotient (ISQ) was significantly higher in type I bone than in type IV bone. At 12 weeks, there was no significant difference among the 3 groups. Comparison of ISQ was made between 6 th week and 12 th week for all bone types, there was no significant difference for type I and III (P > 0.05) while there was for type IV (P < 0.001).

CONCLUSIONSEarly loading with ITI SLA implants placed in type I, III bone were highly predictable.

Bone Density ; Dental Implantation, Endosseous ; Dental Implants ; Dental Prosthesis Retention ; Humans

This study was aimed to investigate the mechanism of histone deacetylase (HDAC) inhibitor, valproic acid (VPA), reversing transcription inhibition of AML1-ETO fusion protein in Kasumi-1 cell line. The mRNA expressions of AML1-ETO, AML1 and cyclin D2 were detected by semi-quantitation RT-PCR after treating kasumi-1 cells with VPA at different doses/and different time points. The results indicated that the mRNA expression of AML1-ETO showed no obvious change, when kasumi-1 cells were treated with VPA. Compared with control group, the expression level of AML1 mRNA significantly increased in a dose-dependent manner. Compared with control group, the expression level of cyclin D2 mRNA significantly decreased when kasumi-1 cells had been treated with 3 mmol/L VPA as well as kasumi-1 cells were treated with different concentrations of VPA for 3 days. In conclusion, VPA could remove transcription inhibition of AML1-ETO fusion protein, increase transcription of AML1 and down-regulate mRNA expression of AML1 target gene cyclin D2 through HDAC inhibiting activity.
Acetylation ; drug effects ; Cell Line, Tumor ; Core Binding Factor Alpha 2 Subunit ; drug effects ; genetics ; Cyclin D2 ; genetics ; Gene Expression Regulation, Leukemic ; Histone Deacetylase Inhibitors ; pharmacology ; Histones ; drug effects ; Humans ; Oncogene Proteins, Fusion ; drug effects ; genetics ; RUNX1 Translocation Partner 1 Protein ; Valproic Acid ; pharmacology