OBJECTIVETo investigate the morphology change of stomatognathic muscles after zygomatic plasty combined with mandibular angel plasty.

METHODS3D-CT facial soft tissue measurement was performed pre-operative and at 10 days,3 months post-operatively in 59 cases with prominent malar-complex and mandibular angle. The q test (Newman-Keuls method) was used to analyze the variance.

RESULTSThe cross sectional area of masseter muscle and medial pterygoid muscle were both increased at 10 days, reduced at 3 months post-operatively (P < 0.05). The masseter muscle and medial pterygoid muscle cross sectional areas were (4.73 +/- 0.21) cm2 and (3.24 +/- 0.21) cm2 at anterior nasal spine plane, respectively; the pterygoid muscle cross-sectional area was (1.37 +/- 0.35 ) cm2 at the root of coronoid process plane, showing significant difference, when comparing with those before operation (P < 0.05). Lateral pterygoid muscle and temporal muscle had no statistical difference between the pre-and 10 days post-operatively(P > 0.05), however, the temporal muscle was reduced while the lateral pterygoid muscle was increased at 3 months post-operatively. The temporal muscle cross-sectional area was(2.35 + 0.25) cm2 at coronoid process plane; the temporal muscle and lateral pterygoid muscle cross-sectional areas were (1.00 +/- 0.16) cm2 and (3.54 +/- 0.61) cm2 at the root of coronoid process plane, which were significantly different from those before operation (P < 0.05 ).

CONCLUSIONSBecause of osteotomy, muscles attached position are changed in the short term after zygomatic plasty combined with mandibular angel plasty. Masseter muscle and medial pterygoid muscle are inevitably injuried during the operation. With the postoperative recovery, muscles have adaptive changes which reduced compared with those before operation after their reattachment. Zygomatic plasty can cause temporal muscle atrophy;while the lateral pterygoid muscle is rarely involved, the cross sectional area had no statistical difference between the pre- and 10 days post-operative, and the cross sectional area increase at 3 months post-operatively may be due to a compensational enlargement.

Female ; Follow-Up Studies ; Humans ; Male ; Mandible ; surgery ; Masseter Muscle ; anatomy & histology ; Osteotomy ; Postoperative Period ; Pterygoid Muscles ; anatomy & histology ; Stomatognathic System ; anatomy & histology ; Temporal Muscle ; anatomy & histology ; Zygoma ; surgery

Esophageal and Gastric Varices ; complications ; prevention & control ; surgery ; Gastrointestinal Hemorrhage ; complications ; prevention & control ; surgery ; Humans

Adult ; Antibodies, Monoclonal, Murine-Derived ; administration & dosage ; therapeutic use ; Female ; Hemophilia A ; drug therapy ; Humans ; Rituximab

Rapid diagnosis is an important link in the prevention and control of infectious diseases.Point-of-care testing(POCT)is portable, fast, easy to operate, intelligent and sensitive, which has been widely used in the detection of pathogenic microorganisms of infectious diseases, host biomarkers, microbial drug sensitivity in recent years.It is of great significance for the monitoring and management of disease epidemiology and rational use of antibiotics.This review summarized the application of POCT in the diagnosis and treatment of pediatric infectious diseases.

Objective To summarize the clinical experience of endovascular intervention for intra-cranial aneurysms, especially in the respect of the technique and management of intra-operative complications. Method The clinical data of 60 patients with intra-cranial aneurysms treated with endovascular intervention in the past 3 years were analyzed. The relevant literature especially with regard to the practical technique described was reviewed so as to potentiall minimize and properly manage the intra-operative complications. Results A total of 69 sacciform aneurysms and one dissecting aneurysm located at left vertebral artery (VA) were detected by using digital subtraction angiography (DSA) in 60 patients. There were 65 saccular aneurysms obliterated with constructive approach, and five of them treated with stent-assisted technique and four of them treated with ballon-assisted technique. The VA dissecting aneurysm was obliterated with coils by deconstructive approach with complete occlusion of its parent vessel. There were a total of 53 complete occlusions of aneurysms accounted for 76.81% of 69 sacciform aneurysms in 51 patients ( 85 % ) and eight subtotal occlusion of aneurysms (95 % ～ 99 % occlusion) accounted for 13.56% of total sacciform aneurysms in five patients (8.47%) and four incomplete occlusion of aneurysms ( ＜ 95% occlusion) accounted for 6.78% of total sacciform aneurysms in three patients (5.08%), and one was failure in operation. The rupture of aneurysms occurred during operation in4 patients (6.78%). Two senile patients suffered from intra-opeartive symptomatic thromboembolisn. One patient had stent shifting and spring coil dislocated and moved into the M3 segment of the ipsilateral MCA. Vasospasm occurred in 15 patients during operation, and most of them received endovascular intervention 3 days after the initial ictus. The rate of good recovery was 93.3% at discharge from hospital (the modified Rankin Scales, mRS＜ 2). There were 55 patients followed up for up 24 months after discharge, and excellent recovery rate was found in 51 patients ( mRS ＜ 2), and 3 died.During the follow-up period, no aneurismal recanalization or rupture was noticed in all patients. Conclusions The endovascular intervention is a safe and effective approach to the intra = cranial aneurysms. Advances in the skill of technique and proper management will decrease the complications during operation and improve the prognosis of patients.

Objective To investigate the the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute non-ST-segment elevation myocardial infarction patients with heart failure.Methods 80 patients with heart failure caused by acute non-ST-segment elevation myocardial infarction were chosen,they were divided into the observation group and control group based on a random number table,each group included 40 patients.The observation group were treated with intravenous injection of recombinant human brain natriuretic peptide,the control group were treated with intravenous nitroglycerin.vital signs,dyspnea,brain natriuretic peptide (BNP),associated hemodynamic changes and adverse reactions of two groups were compared before and after treatment.Results The total effective rate in observation group was 87.5％ (35/40),which were significantly higher than 50.0％ (20/40) of the control group,there were significant difference (x2 =13.09,P ＜ 0.05).In the observation group,after treatment,the left ventricular ejection fraction (LVEF) and average hourly urine output were significantly higher than those of before treatment (t =26.40,3.22,all P ＜ 0.05),and the brain natriuretic peptide (BNP) concentration levels were significantly lower than those of before treatment (t =14.11,all P ＜ 0.05).The control group before and after treatment LVEF,BNP and changes in urine levels were not significantly.Conclusion In the treatment of heart failure caused by acute non-ST-segment elevation myocardial infarction,the recombinant human brain natriuretic peptide (rhBNP) has significant effect,feasible and safe with few side effects,which has a high clinical value.

Objective To explore the construction and application effects of extended care form for children with epilepsy based on Omaha System.Methods Based on Omaha System,the form was established by referring medical records,literature review and three rounds of focus group discussion.From February to June,2016,48 children with epilepsy were selected as the observation group and received routine care as well as management using the form based on Omaha System;from August to December,2015,48 children with epilepsy were selected as the control group and received routine care and follow-up.The effects of intervention and scores of Family Management Measure were compared between two groups.Results Nursing issues in all domains for the observation group 3 months after intervention were lower than those during hospitalization except financial situation (P＜0.05);there was statistically significant difference in scores of knowledge-behavior-status of main nursing issues before and after intervention except cognition and mental health items (P＜0.05).Duration of hospitalization,expenditure,readmission rate,EEG results and scores of FAMM in the observation group were better than those in the control group (P＜0.05).Conclusion The construction and application of the form based on Omaha System can provide references for longterm management for children.

Objective To investigate the possible association of circulating components of GH-IGFs-IGFBPs system with the GHR-exon 3 genotype in idiopathic short stature (ISS) children. Methods Genomic DNA was extracted and isolat-ed from peripheral leukocytes in 108 ISS children. GHR-exon 3 polymorphism was analyzed with multiplex poly-merase chain reactions (PCR) assay. According to the results of genotype, ISS children were divided into GHRfl group and GHRd 3 group. The height and weight were recorded in two groups. The body mass index (BMI) and BMI standard deviation score (SDS) were measured. The serum levels of insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, IGF-1 SDS and IGFBP3 SDS were calculated. GH stimulation test was used to measure the serum GH peak value. Fifty-five ISS chil-dren were treated with recombine human GH [0.15 IU/(kg·d)] for three months to analyse the association of IGF-1 response of GH treatment and genotypes. Results There were 63 GHRfl and 45 GHRd3 in 108 ISS children. There were no signifi-cant differences in BMI, IGF-1, IGFBP3, GH peak, IGF-1 SDS and IGFBP3 SDS between two groups (P>0.05). Multiple stepwise regression analysis showed that age, IGFBP3, lg (BMI) and lg (GH peak) were influencing factors of lgIGF-1 (P<0.05). In 55 ISS children treated with rhGH, there were 34 cases of GHRd3. The differences of △IGF-1 and △IGF-1 SDS were higher in GHRd3 group than those of GHRfl group (n=21). Conclusion The GH sensitivity may be a risk factor in ISS children, which may not be related with GHR polymorphism.

Objective To evaluate the effects of various head and neck postures and phonation on oropharyngeal view(Mallampati score),and ex-plore the correlation with laryngoscopic view tested by the improved Cormach-Lehane score(MCLS). Methods Following the local ethics commit-tee approval and patients′informed consent to anesthesia,124 patients were enrolled for this study. Prior to anesthesia,these patients were placed in supine position with various head and neck positions for oropharyngeal structures visualization and evaluation,including two head positions(neu-tral and full extension),two tongue positions(in and out),and with and without phonation,according to the modified Mallampati test score(MMT). Following induction,laryngoscopic view scores according to MCLS were recorded,then the sensitivity,specificity,positive and negative predictive value and accuracy of the various MMT scores were calculated. Correlation coefficient(r)of MMT scores with MCLS were also studied. Results Mallampati score was decreased in all the postures of head full extension,tongue outside and phonation,which makes oropharyngeal structures to be better visualized. There is no correlation between MMT scores and MCLS. The sensitivity,specificity,positive and negative predictive value and accu-racy of the various MMT scores is most satisfied in the posture of head full extension,tongue outside and phonation. Conclusion During airway as-sessment in supine position,the best posture is head full extension,tongue outside and phonation.

Transcatheter arterial chemoembolization (TACE) was the preferred method of non-operation treatment for hepatocellular carcinoma (HCC).Radical resection of HCC remains difficult,extrahepatic metastasis was not easy to deal with,and repeated treatment aggravated the liver injury,so the long-term efficacy was poor.Sorafenib could control tumor angiogenesis and block the proliferation of tumor cells.A male patient with primary HCC and in the stage Ⅱb according to the Chinese clinical liver cancer staging system was treated by TACE combined with sorafenib and antiviral treatment in Henan Cancer Hospital.After the treatment,the intrahepatic lesions were inactive,and the pulmonary metastasis was partially relieved.The patient was followed up till May 2012,and the survival time was 39 months.The hepatic function was normal,and the hepatitis B virus (HBV) replication was negative.No intervention treatmentrelated complications were detected,and the KPS score was 100.