Objective To investigate the course of the mandibular branch of the facial nerve and to discuss its clinical significant in the rhytidectomy. Methods The distribution of the mandibular branch was observed in 30 halves of the fifteen candaveric specimens (ten antiseptic cadaveric specimens and five fresh cadaveric specimens). Results The mandibular branch could be divided into the isolated branch type and shared branch type, after it exited from the parotid gland. 63.33 % mandibular branch was found (2.1?0.7) cm superior to the palpable edge of the mandibular bone; 23.33 % mandibular branch was along the edge of the bone; and 13.33 % was found (1.8?0.5)cm inferior to the palpable edge of the bone. Conclusion The distribution of the mandibular branch locates in the area that is a digit superior and inferior to the lower border of the mandibular bone, which arises from the angle of the mandibular bone. The dissection beneath the SMAS-platysma should be with caution of the injury of the ramification of mandibular branch in the anterior border of the masseter muscle.[

ObjectiveTo study the transcript atlas of cell immunity-associated genes in 8 liver cell types including hepatocytes, bile duct epithelial cells, oval cells, hepatic stellate cells, sinus endothelial cells, Kupffer cells, pit cells and dendritic cells from the rat regenerating liver. Methods The 8 liver cell types were isolated respectively by Percoll density gradient centrifugation combined with immune magnetic beads separation method. Their expression changes in the regenerating livers were detected by Rat Genome 230 2.0 Array, the expression patterns and the predicted physiological activities of cell immunity-associated genes were analyzed by Cluster program, and the methods of bioinformation and systematic biology. Results A total of 40 cell immunity-associated genes yielded the meaningful expression changes in liver regeneration, the corresponding gene numbers in 8 liver cell types were 19, 19, 9, 19, 19, 21, 22 and 21, respectively. It suggested that the formation of antigen peptide-MHC complexes, the NF-κB kinase activity and the production of cytokines like IL-2 were enhanced at the priming and progressing phases of liver regeneration. The biological activities, such as NF-κB-promoting cell differentiation and caspase-induced T cell apoptosis, were elevated at termination phase.Conclusion The rat liver regeneration is associated with cell immunity.

Infectious endophthalmitis refers to the acute suppurative inflammation of the uveal and retinal, with acute onset, severe symptoms, and poor prognosis.Early diagnosis and effective treatment is particularly important.Based on the way of intraocular infection, endophthalmitis can be divided into endogenous endophthalmitis and exogenous endophthalmitis.In the East Asian, liver abscess is the main source of endogenous endophthalmitis, and Klebsiella pneumoniae is the main pathogen.Liver abscess endophthalmitis is a serious cause of blindness caused by intraocular infection.A liver infection disseminated through hematogenous and the primary focus was hidden, which makes the disease was easy to be confused with immune related uveitis, causing high misdiagnosis rate, delaying the best time for diagnosis and treatment.In this article we reviewed the etiology, clinical features, diagnosis and treatment and prognosis of endogenous endophthalmitis caused by liver abscess.Clinicians should maintain a high index of suspicion to the endogenous endophthalmitis caused by liver abscess.

The incidence of allergic diseases has increased gradually year by year, which gravely influence the quality life, and mental and physical health of children.In view of that, the construction of the health education system in children with allergic diseases is the way to instruct parents and children in children′s health effectively and prevent diseases, thus promoting the healthy growth of children.This article aims to discuss the necessity of health education in children developing with allergic diseases, the establishment of teacher resources systems, the diversity of health education and the organization and management of patients.

Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

Objective:To assess the clinical efficacy of two different diameter Osstem MS one-stage implant restoration of small edentu-lous space in the mandibular anterior region.Methods:85 patients were treated by Osstem MS one-stage implant with the diameter of 2.5 mm(n =66)and 3.0 mm(n =66)respectively for the restoration of small edentulous space in mandibular anterior region.The mesi-al and distal marginal bone level and soft tissue were statistically analyzed after 1 2 and 24 months of functional load.The implant survival rate was evaluated according to Wheeler's survival criteria.Results:The survival rate of the implants was 1 00%.The mean changes in marginal bone level(mm)on the mesial side of 2.5 mm and 3.0 mm diameter implants were 0.275 ±0.638 and 0.098 ±0.31 9,distal aspects were 0.360 ±0.588 and 0.1 09 ±0.323 after 1 2 months of functional load;while 0.299 ±0.672 and 0.099 ±0.31 8,0.381 ± 0.581 and 0.1 07 ±0.31 9 after 24 months of functional load.The mesial and distal marginal bone loss of 2.5 mm diameter implant was greater than that of 3.0 mm after 1 2 and 24 months of functional load(P <0.05).No significant change on the marginal bone level was found aomog the same diameter implants from 1 2 to 24 month observation(P >0.05).No relevant complication of peri-implant soft tissue was shown.Conclusion:Favorable clinical effects including function and aesthetics can be achieved by Osstem MS one-stage implant with the diameter of 2.5 mm or 3.0 mm for the restoration of small edentulous space in the mandibular anterior region,however,the mar-ginal bone loss was greater around 2.5 mm diameter implant.

ObjectiveTo assess the clinical value of procalcitonin (PCT) in the diagnosis of sepsis in adults.Methods An extensive search for related literature from the Wanfang data, CNKI, VIP, Medline/PubMed, Embase/OvidSP and the Cochrane Library up to December 2014 was performed. The articles, including prospective observational studies or randomized controlled trials, regarding PCT for the diagnosing of sepsis were enrolled. Only patients older than 18 years were included. Patients with sepsis, severe sepsis, or septic shock served as the experimental group, and those with a systemic inflammatory response syndrome (SIRS) of non-infectious origin as control group. The language of literature included was English or Chinese. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Heterogeneity, pooled diagnostic odds ratio (DOR), pooled sensitivity, pooled specificity, pooled positive likelihood ratio, pooled negative likelihood ratio, the area under the summary receiver operating characteristic curve (SROC) and subgroup analysis were analyzed with the software of Metadisc 1.4.Results A total of 6 385 published reports were collected, and among them 24 met the inclusion criteria, including a total of 3 107 patients. The studies showed substantial heterogeneity (I2 = 69.4%), and random effect model was used for Meta analysis, showing that the pooledDOR was 10.37 [95% confidence interval (95%CI) = 7.10-15.17]. No evidence of a threshold effect was found (Spearman correlation coefficient = 0.27, calculated by logarithm of sensitivity and logarithm of 1-specificity,P = 0.20). TheDOR values of pooled and each study were not distributed along the same line in forest plots, and Cochran-Q = 78.33,P = 0.000 0, showing that there was heterogeneity in result from non threshold effect. Except for partial heterogeneity caused by non threshold effect, the result of Meta regression analysis including PCT detection method, categories of disease, research location and so on showedP values were all higher than 0.05. Thus, the heterogeneity could not be explained by Meta regression analysis. The pooled sensitivity was 74% (95%CI = 72%-76%), the pooled specificity was 70% (95%CI = 67%-72%), the pooled positive likelihood ratio was 2.79 (95%CI = 2.31-3.38), the pooled negative likelihood ratio was 0.34 (95%CI = 0.28-0.41), and the pooled AUC was 0.83 (95%CI = 0.79-0.87). AUC in medical patients was 0.80 (95%CI = 0.75-0.85), which was higher than that in surgical patients [0.71 (95%CI = 0.65-0.81)].Conclusions Our results indicate a moderate degree of value of PCT for diagnosis of sepsis in adult patients. The diagnostic accuracy in medical patients is higher than that in surgical patients. PCT is a good auxiliary biomarker for diagnosis of sepsis.

ObjectiveTo investigate whether early goal-directed therapy (EGDT) could improve the mortality rate in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed, Cochrane Library, Embase data, Wanfang data, and CNKI from January 1980 to May 2015. Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT), clinical controlled trial (CCT), case-control studies, cohort studies with complete data, which endpoints were the short-term mortality [in-hospital, intensive care unit (ICU) or 28-day] and long-term mortality (60-day, 90-day or 1 year). RevMan 5.2 software was used for Meta analysis of effect of EGDT on mortality rate in patients with severe sepsis or septic shock, and funnel plot was drawn to evaluate the quality of enrolled literature.Results There were 12 studies meeting inclusive criteria including 5 528 patients, 4 RCTs, 3 case-control studies, 4 cohort studies, and 1 quasi-experimental research. It was shown by Meta analysis that EGDT was associated with significant decrease in the short-term mortality [relative risk (RR) = 0.72, 95% confidence interval (95%CI) = 0.64-0.80,P< 0.000 01], but not associated with decrease of long-term mortality (RR = 0.99, 95%CI = 0.92-1.06,P = 0.81). The funnel plot showed that there was no publication bias. EGDT was recommended as grade C.Conclusions EGDT was associated with significant improvement in short-term mortality but not with long-term mortality in patients with severe sepsis or septic shock. Grade C was recommended by our study.

Objective To explore the targeted nursing care for patients with severe traumatic brain injury complicated with intracranial infection. Methods 35 patients of severe traumatic brain injury complicated with intracranial infection from January, 2009 to December, 2011 were reviewed. Results There were 10 cases cured, 12 cases improved very well, 4 cases improved, 5 cases invalid and 4 cases died. The total effective rate was 62.86%and the fatality rate was 11.43%. Conclusion Intracranial infection can be controlled effectively by the venous and intrathecal injection of antibiotics and targeted care in the patients with severe traumatic brain injury.

Objective To explore the comparative advantage of Team based learning (TBL) in common diseases teaching among pre-selected trainees for medical non-commissioned officer. Methods 200 trainees were randomly divided into two groups of equal size (each having 100 trainees), one TBL group and another lecture based learning (LBL) group as the control group. The teaching content was both Chapters of High Altitude Illness and Hypertension. In the LBL control group, the traditional lec-ture based teaching and learning manner was followed. In contrast, the trainees in the TBL group were assigned pre-lecture self-learning outline and questions to discuss in advance, team-based group dis-cussion was conducted, and scene simulation with typical disease case analysis were adopted in class. In both groups, the teaching effectiveness were evaluated by both exam test and questionnaire manner. Results It turned out the team based learning model resulted in significantly improved overall trainee assessment scores (88.90 ± 5.28 vs. 76.10 ± 5.12, P<0.05) and higher overall teacher satisfaction scores (8.63 ± 0.85 vs 7.18 ± 0.72, P<0.05), compared to the LBL group. Conclusion TBL model is more effective in improving trainees' capabilities of cultivating team work spirit, self-confidence, learn-ing enthusiasm, problem analysis and knowledge application. TBL model significantly brings more advantage in teaching pre-selected trainees for medical non-commissioned officer.