Objective: To study the mandibular bilateral sagittal split ramus osteotomy (BSSRO) with bicortical screws rigid internal fixation(RIF) with the three-dimensional finite element method, and supply directions for clinic practice.Methods:CT scanned technology and the finite element software (Ansys) were used to establish the three-dimensional finite element model of BSSRO with bicortical screws RIF. The stress distribution of the mandible and the RIF and the displacement of split mandible were calculated under three kind of occlusion situation.Results:Under the same kind of occlusion situation, the stress and displacement of the split mandible with single upper screws fixation was higher than that with the reverse "L" screws fixation, the stress and displacement of the split mandible with 2.0 mm diameter screws fixation was higher than that with 2.7 mm diameter screws fixation. With the same kind of fixation method, the stress and the displacemen of the mandible under the incisor occlusion was the highest.Conclusion:The fixation distance, position, distribution angle of the bicortical screws all have effects on the fixation stability. The patient should avoid the incisor occlusion after the surgery.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Facial Injuries ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neck Injuries ; therapy ; Retrospective Studies ; Wounds, Penetrating ; therapy ; Young Adult

[Objective] To observe the de-jaundice of severe jaundice hepatitis with TCM enema.[Method] 87 cases of chronic virus hepatitis with hyperbilirubinemia were randomly divided into 2 groups,the treatment group treated with TCM preserving enema and routine combination of TCM and western medicine which could protect liver and decrease enzyme and de-jaundice.The control one used only the later,observed for 6 weeks.[Result] The reduction of total bilirubin of the treatment group was larger than control group,P

OBJECTIVE: To establish a validated infrared spectrum method coupled with cluster analysis, principal component a-nalysis and discriminant analysis for identifying different kinds of Syngnathus. METHODS: Fourier transform infrared (FTIR) spectrometer was performed on the ethanol extracts from 33 samples of Syngnathus collected from different geographical locations. Similarity analysis and cluster analysis were used to establish the reference fingerprint spectra, and principal component analysis and discriminant analysis were used for identifying different kinds of Syngnathus. RESULTS: The experimental results indicated that the samples of same species had the similar characteristic peaks of infrared spectra and could be clustered together. Based on the result of principal component analysis, the absorption peaks(3010.4-3006.5 cm-1, 1745.3-1741.4 cm-1, 1467.6-1463.7 cm-1, 1417.4-1413.6 cm-1, 1168.7-1164.8 cm-1, 723.2-719.3 cm-1, 2925.5-2919.7 cm-1, 2854.2-2850.3 cm-1) were the main characteristic peaks and were used to develop the discrimination function for distinguishing different species of Syngnathus. The accuracy of the discrimination function could reach 98.75%. The established method in the experiment had a good stability, precision and reproducibility, and was a very reliable and useful method for distinguishing different species and assessment of the quality of Syngnathus. CONCLUSION: The established IR fingerprints of Syngnathus's ethanol extracts coupled with mathematical statistics theory could be applied to identify different kinds of Syngnathus. But more importantly, the research job provides a new thought for traditional Chinese medicine identification by using mathematical model.

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Objective To establish an appropriate cut-off value of high sensitivity cardiac troponin T (hs-cTnT) and optimal combination measurement in the early diagnosis of acute myocardial infarction (AMI).Methods This research is a prospective study.342 patients admitted to emergency department with chest pain,43 patients with renal failure,40 patients with pneumonia and 18 premature with patent ductus arteriosus were involved from June 2012 to June 2013 in Peking University Third Hospital.The plasma hs-TnT,NT-proBNP,cardiac troponin Ⅰ (cTnI),CK-MB and copeptin were measured.The distribution of hs-cTnT among associated diseases was analyzed,the diagnostic performance of hs-cTnT and the role of combination hs-cTnT with NT-proBNP,CK-MB and copeptin were evaluated by receiver operating characteristic (ROC) curve.The statistical method was used to calculate the Sensitivity,specificity,negative predictive value and positive predictive value of hs-cTnT in the diagnosis of AMI.Results As compared to patients with STEMI(median 0.52 μg/L,range 0.037-7.610 μg/L),hs-cTnT was lower in the patients with Non-STEMI(median 0.127 5 μg/L,range 0.021-4.260 μg/L).However,the levels of hs-TnT in other diseases were also increased increased in varyng degrees (Chi-square =76.432,P ＜ 0.05)The areas under the curve (AUC) for hs-cTnT and cTnI in the diagnosis of AMI were 0.862 (95％ CI:0.729-0.928) and 0.748 (95％ CI0.666-0.818) respectively (Z =2.713,P ＜ 0.05).Taking 0.014μg/L and 0.035 μg/L as cut-off value of hs-TNT,the sensitivities were 100％ vs 95.1％,the specificities were 44.4％ vs 65.7％.The combination of hs-cTnT,NT-proBNP,CK-MB resulted in a increase in AUC (0.915,95％ CI:0.838-0.964) (Z =2.147,P ＜ 0.05) and the combination of hs-cTnT and copeptin resulted in a increase in AUC 0.921 (95％ CI:0.820-0.975) (Z =2.589,P ＜ 0.05).Conclusion With the cut-off value of 0.035 μg/L for diagnosis of AMI was appropriate,and the combination measurement can improve the accuracy of early diagnosis of AMI.

Objective To inject PPTA into the cochlea of guinea pigs through scala tympani fenestration ,to study the protective effect of PPTA injection on the cochlear damage induced by gentamicin and mechanism of oxy-gen free radical .Methods Randomly divided were the guinea pigs with normal hearing into three groups :the con-trol group ,GM group and PPTA group .We injected the artificial perilymph 10μl /d into cochlea through scala tym-pani fenestration on control group for 3 days ,injected GM 160 mg · kg -1 · d-1 on GM group for 3 days ,injected the PPTA 10 μl /d into the cochlea through scala tympani fenestration and injected GM 160 mg · kg -1 · d-1 at the same time on PPTA group for 3 days .We tested ABR and analyzed the hearing changes .We tested the OFR level reacted by SOD and GSH of the cochlea tissue .SEM and TEM were performed to observe the change of cell mor-phology .Results For ABR ,the control group was 12 .75 ± 3 .796 ,GM group 28 .230 ± 4 .953 ,PPTA group23 .47 ±9 .211 dB SPL(P<0 .05) .For SOD ,the normal group was 50 .241 ± 9 .080 ,GM group 28 .230 ± 4 .953 ,PPTA group 43 .089 ± 4 .587 U/mgprot(P<0 .05) .For GSH ,the normal group was 3 .03 ± 0 .33 ,GM group 1 .51 ± 0 .13 ,PP-TA group 2 .50 ± 0 .16 Ggsh/L(P<0 .05) .The changes of hair cells of PPTA group were obviously less severe than that of GM group .For TEM ,the changes of spiral ganglion and stria vascularis of PPTA group were obviously less severe than that of GM group .Conclusion Injecting PPTA through scala tympani fenestration can protect cochlea by generating the excess of OFR when confronting against GM .

Objective To biomechanically study the fixation stability of different numbers and shapes of the titanium miniplates (L-shaped and straight four-hole miniplates) in the treatment of maxillary LeFortⅠ fracture by using three-dimensional finite element method so as to provide reference for clinical treatment of the fractures. Methods Three-dimensional finite element model of maxillary LeFortⅠ fracture was established with four kinds of rigid internal fixation (RIF) methods to calculate the stress of the maxilla and the RIF as well as the displacement of the fracture segment under three kinds of occlusion.Then, the fixation stability of different methods was compared. Results Under the same occlusion condition, the decreasing order of the displacement of the fracture segment was the L-shaped plate fixation at both buttress of the maxillary and nasal maxillary zygomatic, the straight four-hole miniplates fixation at both buttress of the maxillary and nasal maxillary zygomatic, the L-shaped plate fixation at the zygomatic maxillary buttress and the L-shaped plate fixation at naso-maxillary buttress. Under the same fixation method, the decreasing order of the displacement of the fracture segment was molar occlusion, premolar oeclusion and incisor occlusion. Conclusions The fixation stability of the L-shaped plate fixation is better than the straight four-hole miniplate fixation for the treatment of LeFortⅠ fracture. Fixation at the zygomaticmaxillary buttress is better than at the naso-maxillary buttress. Use of only two miniplates to fix the LeFort Ⅰ fracture may not be stable. Molar occlusion is not good for fracture healing.

Adolescent ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Rickets ; prevention & control ; Vitamin D ; therapeutic use

Objective:To investigate the strategies and methods of pancreatic cancer immunotherapy adopt cytotoxic T lymphocytes activated by dendritic cells(DCs),which modified by heat shock protein 70 peptide complex(HSP70-PC).Methods:HSP70 peptide complex from lumps of tumor-bearing mouse innoculated with pancreas cancer cell(MPC83)were purified by ConA-Sepharose and ADP-Agarose affinity chromatography.Dendritic cells derived from normal murine bone marrow were induced by GM-CSF and IL-4.MTT method was applied to analyses the proliferation activities of DCs.To achieve the specific T lymphocyte cells,DCs modified with HSP70 peptide complex were coculture with murine spleen lymphocytes for 48 hours.Then these activated lymphocytes were cocultured with MPC83 at ratio of effect-target 10∶1 and 20∶1 in vitro and the killing activities were detected by MTT method.Results:High purify HSP70-PC was obtained;104 DCs need 50～100ng of HSP70-PC to modify,100?g of HSP70-PC peptide complex can be extracted from per 1g lump;T cells stimulated by HSP70-PC modify DCs showed more specific cytotoxic activity to MPC83 than lymphocytes activated by DCs without HSP70-PC in vitro.Conclusion:We can extract high purity HSP70-PC for clinical individual immunotherapy from pancreatic cancer lump by using hypobaric affinity chromatography;DCs vaccine modified with HSP70-PC has significant kill effect against pancreatic cancer cell in vitro.