In the clinical education of oral and maxillofacial plastic surgery,how to enhance students’study enthusiasm and interest,promote them to carry on the ponder,and sharpen their generalized analysis ability is a challenge for the OMPS(oral and maxillofacial plastic surgery) teachers.This article proposes a new teaching method:the stereo teaching method,and evaluate its effect.

BACKGROUND: It is now know that the clinical presentations of subcortical arterioselerotic encephalopathy(SAE) could be mainly manifested by hypertension,stroke and chronic developed dementia,but there are very a few explorations on its definite pathogenesis and earlier assessment.OBJECTIVE: To investigate the correlation of CT classification of SAE with intellectual and neuropsycholohical disturbance,so as to explore the significance of CT classification of SAE to the assessment of SAE.DESIGN: Clinical case analysis based on patients.SETTING: A department of internal medicine in a military general hospital of Chinese PLA.PARTICIPANTS: From January 1999 to December 2002,totally 68 elders Guangzhou Military Area Command of Chinese PLA,included 65 males and 3 females,aged from 64 to 93 years old with the average age of(75. 8 ± 8. 1 )years old took part in the study.METHODS: Low-density focus around ventricle were observed with skull CT scanning and classified according to GOTO classification. Meanwhile the intellectual test and neuropsycholohical test were carried out,and the correlative analysis was conducted.MAIN OUTCOME MEASURES: Intellectual test,neuropsycholohical test,skull CT scanning,and analysis of correlation of CT classification with scores of intellectual test and neuropsycholohical test.RESULTS: Of 68 patients,91% (62/68) was proved to have different degree intellectual obstacle,100% was found to be vascular dementia; and low-density focus around ventricle were proved to be existed in all patients with skull CT scanning,GOTO classification indicated that type Ⅰ was found in 22 patients,type Ⅱ in 32 patients and type Ⅲ in 14 patients; skull CT classification was negatively correlated with the scores of intellectual test and positively correlated with scores of neuropsychiological test,with the correlative coefficient of -0. 83 and 0.75 respectively( P ＜ 0.01 ).CONCLUSION: GOTO classification of skull CT of SAE is related to intellectual obstacle and neuropsychiological disturbance in elder SAE.

Argentina ; epidemiology ; China ; epidemiology ; Cross-Sectional Studies ; Hemophilia A ; diagnosis ; epidemiology ; therapy ; Humans ; Prognosis ; Russia ; epidemiology ; Surveys and Questionnaires ; United States ; epidemiology ; Urban Population

AlM: To evaluate the effect of rigid gas permeable contact lens ( RGP ) in correcting high myopia and astigmatism.METHODS: Forty-one patients ( 65 eyes ) with myopia (-9. 03 ± 6. 19DS, maximum -23. 00DS) and astigmatism (-1. 41 ± 1. 32DC, maximum -5. 50DC) were fitted with RGP after strict routine ophthalmological examination, objective refraction and subjective refraction. All these patients were followed after 1wk, 1, 3mo and half one year.RESULTS:Sixty-five eyes were fitted with RGP (-9. 92± 5. 96DS). RGP base curve ( BC) was majorly located within the range 7. 20 ~8. 25mm. 46. 2% eyes with RGP achieved 1. 0 ( BCVA ) and 80. 1% achieved above 0. 6 ( BCVA) . However, with spectacles, the percent was 28%(1. 0) and 60% (>0. 6), respectively. BCVA of RGP was 0. 81 ± 0. 22, but BCVA with spectacles was 0. 66 ± 0. 28, there was statistical significance (P<0. 01). There were 40 eyes (62%) fitted with RGP whose vision were enhanced more than 1 line, 24 eyes ( 37%) whose vision were not changed and 1 eye (2%) whose vision were dropped 1 line.CONCLUSlON:RGP effectively improves visual acuity of high myopia and astigmatism compared with spectacles.

OBJECTIVETo investigate different treatment methods for stage-Is testicular mixed germ cell tumors (TMGCTs).

METHODSWe retrospectively analyzed the clinical data about 3'cases of stage-Is TMGCTs (aged 26-39 years) treated in the 175th Hospital of PLA, reviewed relevant literature, and explored the clinical characteristics of TMGCTs.

RESULTSOf the 3 patients, 1 was treated by radical orchiectomy, 1 by radical orchiectomy + retroperitoneal lymph node dissection + BEP chemotherapy scheme, and the other by radical orchiectomy + radiotherapy. The pathological components of TMGCTs were immature teratoma, seminoma, spermatocytoma, chorioepithelioma, embryonal carcinoma, and yolk sac tumor. No recurrence or distant metastasis was found during the 24-month follow-up after surgery.

CONCLUSIONThe diagnosis of TMGCTs primarily depends on physical examination, ultrasonography, MRI, and measurement of serum tumor markers, while its confirmation necessitates pathological examination, and its treatment is basically radical orchiectomy.

Adult ; Carcinoma, Embryonal ; pathology ; Endodermal Sinus Tumor ; pathology ; Humans ; Lymph Node Excision ; Male ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplasms, Germ Cell and Embryonal ; pathology ; surgery ; Orchiectomy ; Retrospective Studies ; Seminoma ; pathology ; Teratoma ; pathology ; Testicular Neoplasms ; pathology ; surgery

Objective To explore the imageologic characteristics of pelvic fractures with artery injuries and the treatment methods for embolization of arteries.Methods From January 1999 to June 2005,60 cases(42 males and 18 females)aged 21-52 years(average 34.5 years)with pelvic fractures and unsteady blood dynamics were admitted into our hospital.There were 32 cases with traffic injury,13 with crushing injury,nine with fall injury and six with other injuries.The mean injury severity score was 39?16(16-66).All cases were hypetensive with systolic blood pressure less than 90 mm Hg on the arrival.Routine X-ray examination of dorsaventral,debouch and porch of pelvis was performed.The aver- age amount of blood transfusion was 2 886 ml.All cases underwent iliac artery angiography and pelvic ar- teriography.Results X-ray examination of pelvic fractures showed posterior pelvic fracture in 25 ca- ses,with 64 branches of blood vessels injured;anterior pelvic fracture in 13,with 17 branches of blood vessels injured;acetabular fracture in six,with 12 branches of blood vessels injured;and combined pel- vic fracture in 16,with 36 branches of blood vessels injured.Three cases died,with mortality rate of 5%.One case with common arterial thrombosis was treated with artificial blood vessel transplantation, four cases with external iliac artery injuries including one with artery rupture were treated with prosthesis, and among the three cases with external iliac artery thrombosis,one was treated with dislodgment of thrombosis,one treated with recanalization of thrombolysis and one did not give any treatment.Fifty cases with injury and bleeding of internal iliac artery and its branches were treated with arterial embolization. Five cases showed no obvious injury.Conclusions The types of artery injuries can be predicted through X-ray of pelvic fracture.Posterior pelvic fracture may easily cause injury to superior gluteal arter- ies,iliac lumber arteries,and lateral sacral arteries.While anterior pelvic fracture will cause injury to obturator arteries.Superior gluteal artery is susceptible to injury.Embolization of injured arteries and an- astomosis are preferred treatment for pelvic arterial disruptions.

Objective To introduce the mini-open anterior correction under video assisted thoracosco- py for thoracic idiopathic scoliosis and report its clinical results.Methods From July 2001 to 2006,37 ca- ses of right thoracic idiopathic seoliosis were surgically corrected with mini-open anterior instrumentation. There were 4 males and 33 females with average age of 14.1 years and average Cobb angle of 56?.Fourteen cases with Lenke I A 14 cases,IB ++-++++ 14 cases,IC 9 cases.The Risser sign was ++-++++. The operative time,blood loss,instrumented levels,correction rate and loss of correction were analyzed. Results The operative time averaged 220 miu.The intraoperative blood loss averaged 320 ml.The average number of instrumented levels was 7.8.The postoperative Cobb angle was 16.8?on average with correction rate of 70%.With a follow-up of 18-36 months,the loss of correction averaged 4.6%,but no hardware complications.Conclusion The clinical results of mini-open anterior correction under thoracoscopy for tho- racic idiopathic scoliosis were satisfactory.It may minimize the complications of classical thoracotomic anterior correcion and mav reduce the high requirement for anesthesia,long operative time and high cost of thoraco- scopic anterior instrumentation.

Objective To analyze the clinical characteristics and the outcome of severe trauma of various ages in emergency department,to improve the therapeutic effect of emergency rescuing.Methods Two thousand and sixty nine patients of severe trauma were treated during a seven-year period from October 1997 to October 2004.The studied patients were divided into 5 groups:(1)adolescent group(Group A,＜13 years old,n=106);(2)juvenile group(Group B, 13-18 years old,n=128);(3)youth group(Group C,18-40 years old,n=1518);(4)middle age group(Group D, 40-60 years old,n=215);and(5)elderly group(Group E,＞60 years old,n=102).All the patients were evaluated with Injury Severity Score(ISS),and the result was≥16 in all of the studied patients.Results The incidence of severe trauma in male in all 5 groups was higher than that in female,and it was significantly higher in Group C,Group D and Group E when compared with that in the other groups(P＜0.01).Traffic accident was the leading cause of injury,and its incidence in Group A,Group B and Group D was higher than that in other groups(P＜0.01).However,injury caused by falling from high places was the second cause of injury,being significantly increased in Group A,while armed fighting and injury during work being significantly increased in Group B,Group C and Group D,slip fall injury being significantly increased in Group E(P＜0.01).Head injury was mainly found in Group A and Group E,extremities injury and/or spinal injury were increased markedly in Group B,Group C and Group D(P＜0.05),abdominal injury was significantly decreased in Group E(P＜0.001).The total mortality was 11.9%(246/2069).The mortality within 24 hours (20.6%,21/102)was significantly higher than that beyond 24 hours(7.8%,8/102)in Group E(P＜0.01).The time of staying in the emergency department differed significantly between the survived patients and those died in all 5 groups (P＜0.01).Conclusion The gender,the incidence and the characteristics of the injury causes and injury sites differed between severely injured patients of various ages.Mortality in the elderly is significantly increased following severe trauma. The idea of“golden one hour”and“platinum ten minutes”,measures of shortening the time of staying in the emergency clinic,early definite operation and damage control operation should be emphasized.

The effect of the complement C1q expression on total hepatic ischemia-reperfusion (I/R) injury in rats was investigated. Sixty healthy male Sprague Dawley (SD) rats weighing 180-200 g were randomly divided into 5 groups: sham-operation group (S group, n=12); group of I/R for 1 h (I/R 1 h group, n=12); group of I/R for 3 h (I/R 3 h group, n=12); group of I/R for 6 h (I/R 6 h group, n=12); group of I/R for 24 h (I/R 24 h group, n=12). The hepatic I/R model of rats was established, and liver tissues were obtained 1 h, 3 h, 6 h and 24 h after hepatic I/R, respectively. Furthermore, the tissues were stained using hematoxylin-eosin, and the liver injuries of rats were observed using a microscope. The malondialdehyde (MDA) level and superoxide dismutase (SOD) activity in liver tissue were determined. Real-time polymerase chain reaction (PCR) and Western blotting were used to detect the expression levels of C1q mRNA and protein, respectively. As compared with the S group, the histopathological changes in I/R 1 h-24 h groups were gradually aggravated with the extension of I/R time. As compared with the S group, SOD activity and MDA content in the I/R groups were reduced and increased respectively with the extension of I/R time (P<0.01). Furthermore, the C1q expression at mRNA and protein levels in the I/R groups (especially in the I/R 3 h group) was significantly higher than that in the S group (P<0.05). It is suggested that C1q expression may play a principal role in hepatic I/R injury, particularly at the early stage of perfusion.

Objectives To investigate the expression of matrix metalloproteinase-9 (MMP-9) and its tissue inhibitor (TIMP-1) in cutaneous squamous cell carcinomas (SCC) and the relationship between the expression and invasive growth and metastasis of SCC. Methods Immunohistochemical method of streptavidin-peroxidase (SP) was used to detect the expression of MMP-9 and TIMP-1 proteins on the paraffin embedded sections of 65 patients with cutaneous SCC and 5 cases of normal epidermis. The immunohistochemical results were analyzed quantitatively using an image analysis system. Results MMP-9 and TIMP-1 proteins were diffusely expressed on the tumor nests and the mesenchymal cells around the nests, while in normal epidermis MMP-9 and TIMP-1 were weakly positive. The expression level of MMP-9 protein and the ratio of MMP-9/TIMP-1 were higher in aggressive SCC group than those SCC in situ group (t = 2.33 and 2.36, respectively, P