Objective To explore and estimate a new non-operative treatment of maxillary fracture with elastic traction for the purpose of early treatment and on-spot first aid. Methods 12 patients, who were suffer from maxillary fracture including Lefort Ⅰ, Ⅱ, Ⅲ fracture, zygomatico-maxillary complex fracture and nasomaxillary complex fracture within the past 2 or 3 weeks,were treated by closed tractive reduction with a patent craniomaxillary tractive device, a non-operative manner instead of surgical open reduction and rigid internal fixation. The devices were placed after dental splints had been ligated, and the traction force was adjusted depending on the extent of maxillary displacement and patient’s endurance. In general, the displaced maxilla could be pulled upwards, downwards, forward, leftward and rightward. For fallen maxilla, a special plate was placed on upper teeth and palate in order to push up the whole maxillary fragments. By adjusting the position of maxillary bar, the displacement could be reduction and correction. The elastic rubber loops were placed between dental splint and headframe, then the reduction of maxilla was accomplished. After reduction, external fixation such as intermaxillary fixation and craniomnetal bandage were used for maintenance. Results Tractive times of those 12 patients lasted from 2 days to 7 days, with an average of 4 days. After the non-operative trative reduction, satisfactory functional and cosmetic results were achieved with normal occlusion and facial contour in all patients. No obvious complications were found. Conclusion For fresh maxillary fracture except comminuted and impacted fracture, this new non-operative tractive treatment could be an ideal treatment rather than surgical open reduction.

Objective To introduce the newest type of mouth-gag for cleft palate palatorrhpy.Methods The instrument consisted of forcipal retractor,tongue-spatula,and spatula fixatiou screw post.Results Its structure was simple,light-weight and small.The operation was convenient and the fixation is firm.It gave a clear field of vision for surgery.Conclusion The new-type cleft palate palatorrhphy solves the problems in the old-type one.

Objective To investigate the effect of tail vein injection of exogenous bone marrow mesenchymal stem cells (BMSCs) on proliferative,osteogenic and adipogenic potential of BMSCs in ovariectomized osteoporotic rats.Methods The animal model of osteoporosis (OP) was established 3 months after ovariectomy (bilateral ovarian resection)in healthy 10-week-old female SD rats with the same batch and weight.The healthy 8-week-old SD GFP rats were selected in the same way as the BMSCs source.The experiment was divided into BMSCs group and control group.The BMSCs (1×106) marked with GFP were injected into BMSCs group rats by tail vein injection.One week after injection,BMSCs were isolated,cultured and purified in vitro to the 3rd,4th passage in all groups.The MTT method was used to detect the growth curves of BMSCs.The oil red O dyeing and alizarin red staining (ARS) were used to compare the adipogenic and osteogenic potential between the two kinds of BMSCs,respectively.The RT-PCR was used to detect the expression of osteogenesis-related genes (Runx2,osteocalcin and osteopontin) and adipogenesis-related genes (PPARγ and LPL) in BMSCs.Results Compared with the control group,the growth curve of BMSCs in BMSCs group rose significantly; the calcified nodule increased significantly after osteogenic induction; the lipid droplet decreased significantly after adipogenic induction.RT-PCR results showed that the Runx2,osteocalcin and osteopontin mRNA expression increased,while the peroxisome PPARγ and LPL mRNA expression decreased in BMSCs group.Conclution By tail vein injection of exogenous BMSCs,the proliferative and osteogenic potential of BMSCs in ovariectomized osteoporotic rats is enhanced,while the adipogenic potential is reduced,which provides a possibility of stem cell therapy for osteoporosis.

Objective To observe the substance P(SP) and calcitonin gene-related peptide(CGRP) expressions in the temporomandibular joints(TM J) of the rats undergone emotional stress and explore the relationship between emotional stress and temporomandibular joint disorder(TMD). Methods Ninety SD rats were averagely randomly divided into emotional stress ( ES ) group( n = 30 ), electric foot-shocked (FS) group ( n = 30 ) and control (CON) group( n = 30). The emotional stress was induced by communication box. The TMJ tissues in ES and CON groups were removed after 1, 3 and 5 weeks of emotional stress for scanning electron microscope ( SEM ) test and immunohistochemistry test. The SP and CGRP expressions were examined with SABC immunohistochemistry and then analyzed by image analysis system. Results The expressions of SP and CGRP had significant difference after 1 ,3 and 5 weeks emotional stress ( SP: 124.5 ± 16.9,185.6 ± 1.8 and 193.5 ± 3.5, respectively; CGRP: 185.9 ±5.3, 112.5 ±5.2 and 174.3 ±5.3 ,respectively) (P＜0. 05 ). The SEM results showed that there was a series of structural change on the condylar surface after emotional stress. Conclusion The SP and CGRP energy nerve fibers take part in the TMJ pathological process undergone emotional stress.

Objective To investigate the role of psychological intervention in the prevention of the temporomandibular joint disease (TMD) , through the observation of the relative changes in the rat TMJ under psychological stress after psychological intervention. Methods The rat model of communication box was built to exert the psychological stress. The antianxiety agent was applied before stress, and the stressor was removed after stress. The expression of the proinflammatory cytokines IL-1 and TNF-α in the mandibular condylar chondrocytes in rat TMJ was detected by ELISA and RT-PCR. Results The RT-PCR results showed that the expression of IL-1 mR-NA increased into the peak in the 1st week, weakened in the 3rd week, and returned to normal in the 5th week, while the TNF-αmRNA peaked in the 1st week, returned to normal in the 3rd week. The ELISA results showed that there was no significant difference of the OD value of the serum IL-1 and TNF-α(0. 095 ±0. 006,0. 077 ± 0.007,0.069 ±0.009 ;0.079 ±0.010,0.075 ±0. 009,0.079 ± 0.012) in the antianxiety agent group (0. 107 ± 0.024,0. 101 ±0.005,0.088 ±0.010)and the stressor removal group(0. 090 ±0.016,0. 088 ±0.005,0.089 ± 0.011) , compared with the control group(0.087 ±0.004,0.090 ±0.009,0.089 ±0.010;0.074 ±0.008,0.069 ±0.015,0.068 ±0.011) (P>0.05), while significant differences were observed when compared with the psychological stress group(0.282 ±0.045,0.226 ±0.021,0.092 ±0.002;0. 164 ±0.009,0.123 ±0.013,0.091 ± 0.006) (P<0.05 ). Conclusion Application of the antianxiety agent and stressor removal could effectively counter the influence of psychological stress to TMJ, which provides good experience for the clinical prevention of TMD.

Objective To investigate the repair effect of low intensity ultrasound on radioactive mandibule bone to provide new idea for prevention of osteoradionecrosis of the mandibule after irradiation.Methods The animal models of radioactive mandibular injury were made and treated with low intensity ultrasound.Low intensity ultrasound treatment group ( Group Ⅱ ) and not with low intensity ultrasound treatment group (Group Ⅰ ) were observed by microvessel density detection,micro-CT,ponceau trichrome stain and so on,and compared with control group.Then,the obtained data were statistically analyzed.Results The animal models of radioactive mandibular injury were successfully established.The microvessel density in Group Ⅱ was greater than that in Group Ⅰ.The bone volume fraction,trabecular thickness,bone surface/bone volume and the trabecular number in Group Ⅱ were significantly larger than those in Group Ⅰ (P ＜ 0.05).The ponceau trichrome staining showed that the osteocytes largely disappeared and that the cancellous bone trabecular atrophied in Group Ⅰ,while new bone formation,trabecular and numerous osteoblasts around trabecular were largely observed in Group Ⅱ.Conclusion Low intensity ultrasound has a good recovery effect on bone tissue after irradiation.

Objective To compare the operative cooperation of da Vinci robotic surgery and traditional laparoscopic surgery, so as to provide evidence to qualify the operative cooperation of minimally invasive operation. Methods Comparison of the operative cooperation with related experiences and literature was made between the two kinds of surgeries. Results More requirements were put forward during the da Vinci robotic surgery on nurses′ service quality and training methods, ethics & law knowledge and humanistic care, equipment installation and preparation, complicated nursing performance content, system error handling and postoperative management, etc.. Conclusions It is suggested that the operative cooperation of the precise minimally invasive operation should be improved as follows:strengthen the nurses′ special training and continuing education; establish related operation process and management standards;do patients′explanation work and surgical team cooperation.

Objective:To establish an animal model of bone distraction in the irradiated dog mandible.Methods:1 0 Chinese dogs were used.8 dogs received a unilateral irradiation of 60 Co(Group R)in the mandible with a total dose of 22.8 Gy in four 5.7 Gy frac-tions (biologically equivalent to 50 Gy/25 fractions).The other 2 dogs without irradiation served as the controls(Group C).Bilateral corticotomy was made 3 months after completion of irradiation.After a 1 -week latency period,bone distraction was activated at a rate of 0.5 mm twice daily for 1 0 days,followed by a consolidation phase of 8 weeks.New bone was evaluated by radiographic,histological and single photon emission computed tomography(SPECT)analysis.Results:One dog was excluded from the study due to anaesthetic death in group R.After 8 weeks of consolidation,no difference was found between the percent area of new bone of both groups.New bone was more mature and organized in Group C than that in Group R.SPECT analyses showed that there was active osteogenic activity in Group R.Conclusion:Distraction osteogenesis can be achieved in the irradiated dog mandible.

Objective To observe the correlation between long-term chronic pharyngitis and rheumatic heart vavular disease (RHD) caused by to long-term latent chronic rheumatic activity and to understand the progressive course of rheumatic heart vavular disease. Methods In 1126 cases with chronic pharyngitis, 319 cases with serum antistreptolysin O (ASO) level between 400-500 U/ml were followed-up. ASO, creatine kinase enzyme MB (CK-MB) and echocardiography were measured for follow-up since 1986. Of the 319 cases, 158 were male and 161 were female with the average age of 29.4 years old. By the end of 2009, 6 cases were lost during follow up, data of 313 cases including 155 male patients and 158 female patients whose average age was 49.6 were analyzed. As the number of every kind of rheumatic heart vavular lesion was so fewer for statistical analysis that the data were only listed in tables. The student's t test was performed to compare of the ASO, CK-MB between the group with vavular lesionss and the group without vavular lesion. Results ①Of the 313 cases, 9 cases suffered from rheumatic fever at the fourth year since 1986, and 29 cases had rheumatic fever 1, 2 or 3 years after the ASOs decreased to lower than 400 U/ml and no one developed heart valvular lesion.②Two hundred and seventy-five cases whose ASO in the range of 400-500 U/ml but with normal CK-MB were found by the end of 5, 10, 15, 20 years, 9, 42, 65, 78 cases had developed heart vavular diseases respectively. ③ The levels of CK-MB in the heart valvular disease groups were significantly higher than those in the non-vavular disease group, while the levels of ASO were not. Conclusion Some of the cases suffering from long-term chronic pharyngitis can have high levels of ASO, but with normal CK-MB. These patients may have latent long-term chronic rheumatic activity and develop rheumatic heart valvular disease years later.

Objective To investigate the possible mechanisms of the attribution of psychological stress to the temporomandibular joint disorder(TMD) ,through the evaluation of the animal model and detection of the proinflammatory cytokines in the TMJ.Methods The animal models of communication box were built to mimic the psychological stress.The concentration of the serum Cor and ACTH was detected in the control group, Psychological Stress group ( PS group), and diazepam ( anti-anxiety drug) group ( PS + DI group).The expression of the proinflammatory cytokines IL-1 and IL-6 in the rat TMJ in the different phases of psychologicalstress was detected by RT-PCR.Results The results of the serum concen- tration of Cor and ACTH showed that there was significant difference between the control group and the PS group(P＜0.01 ) ,while no significant difference between the control group and the PS + DI group(P＞0.05).The expressions of IL-1 and IL-6 were comapared in all group.The expressions of IL-1 in CON group were (0.453± 0.021 ) mg/L, (0.439 ± 0.028 ) mg/L and (0.454 ± 0.023 )mg/L.These values were markedly increased compared with those of the PS group(0.981 ±0.024)mg/L, (0.746±0.017)mg/L and (0.510 ±0.016)mg/L respectively, P＜0.01 ) ,but no significant differences compared with PS + DI group(0.549 ± 0.014 ) mg/L, ( 0.498 ± 0.014 ) mg/L and ( 0.444 ± 0.022 ) mg/L respectively, P ＞ 0.05).Similar changes were observed in expressions of IL-6.The expressions of IL-6 in the CON rats were (0.525 ±0.028)mg/L,(0.515 ±0.028)mg/L and (0.518 ±0.022)mg/L,respectively,while those of PS group were(0.820 ± 0.023 ) mg/L, (0.694 ± 0.019 ) mg/L and (0.579 ± 0.015 ) mg/L, respectively, which were significan- tly higher in the PS groups(P＜ 0.05 ).But there were no significant differences between CON group and PS + DI group( (0.599 ±0.015)mg/L, (0.541 ±0.015)mg/L, (0.487 ±0.008)mg/L respectively, P＞0.05).Conclusion The psychological stress can play important role in the formation of TMD.