Objective To investigate the clinical application of free submental flap for defects reconstruction after oral cancer ablation.Methods Eleven cases of free submental flaps for defects reconstruction after oral cancer ablation from April,2013 to May,2014 were reviewed.The primary disease,defect type,flap side,flap size and flap survival rate were recorded.The follow-up data of tumor recurrence,lymph node metastasis,as well as postoperative facial appearance and function of marginal mandibular branch of facial nerve were collected.Results Primary disease of all 11 cases was oral squamous cell carcinoma.No flap failure was reported and the overall flap survived.The follow-up period was 6-18 months with the average of 9 months.There was no tumor recurrence and metastasis of lymph node.Postoperative facial appearance was satisfactory and there was no nerve injury of marginal mandibular branch which showed normal and symmetrical expression motion.Conclusion Free submental flap owns many ad vantages including constant anatomy,long vascular pedicle,wide range of indications and low donor-site morbidity.Contralater submental flap may avoid potential lymph node metastasis.Free submentai flaps is an ideal choice for reconstruction of oral and maxillofacial defects after cancer ablation.

Objective To explore the effect of lead acetate on the growth of murine mesenchymal stem cells in vitro.Methods 40.00,60.00 and 100.00 ?mol?L-1 of lead acetate were used in the culture of colony-forming unit-fibroblast(CFU-F),the effect on the rate of colony-forming and the rule of variation were observed.Results The rates of colony-forming were(3.30?0.20),(2.40?0.10) and(1.57?0.21)/105,when the doses of lead acetate were 40.00,60.00 and 100.00 ?mol?L-1 and there were significant differences compared with control group(4.20?0.20)/105,P

Medical insurance payment reform is an important part of healthcare reform in China. Based on the practice and research of China Rural Health Project ( hereinafter referred asHealth XI Project) financed by World Bank (WB) and UK Department for International Development (DFID) implemented in 40 counties of 8 Chinese provinces between 2009 and 2014 , this thesis analyses the principle and feasible policy route of medical payment re-form for the country, by ways of reviewing the policy evolution, and summarizing the process of project pilot from sin-gle mode of payment-a simple mixed payment-to the comprehensive payment system reform and analyzing the advanta-ges and disadvantages of medical insurance payment methods.

BACKGROUND: Osteochondral allograft transplantation for the treatment of knee articular cartilage defects is one of the longest clinical methods. Although this method is widely used in clinical practice and is trusted by orthopedic surgeons, it still lacks evidence-based medicine support. OBJECTIVE: To investigate the efficacy of osteochondral allograft transplantation in the knee joint, systematic review and meta-analysis of all available data, and evaluate the efficacy and safety of osteochondral allograft as a transplant substitute in knee joint surgery. METHODS: Literature search was conducted in PubMed/Medline, EMBASE, Cochrane Collaboration Library, China National Knowledge Infrastructure and Wanfang Database. The application of osteochondral allograft in knee joint transplantation was searched and selected according to the literature inclusion criteria. Articles whose data can be extracted and meta-analyzable were mainly selected. RESULTS AND CONCLUSION: (1) Twenty-five studies met the inclusion criteria and were all case series studies. The patient reported that osteochondral allograft can be used as a graft material to repair knee joint defects. A total of 1 081 patients (1 111 knees) were included in the study. The age of onset was 11-75 years old, with an average age of 34.41 years. The proportion of women was about 40.81%. The follow-up period was 4-384 months, with an average of 76.8 months. (2) In these studies, donors received a minimum age of 10 years and a maximum of 65 years. According to the donor age range and number of studies, donors aged 15-45 were the primary targets. (3) The overall success rate after surgery was 74%, and the overall secondary operation rate was 17%. The success rate of unipolar surgery was 74.44% (501/673); the success rate of bipolar surgery was 50.94% (27/53). The success rate of unipolar surgery was significantly higher than that of bipolar surgery (χ2 =13.679, P < 0.05). (4) Treatment complications occurred in 67 patients (13.14%, 67/510). Common complications were persistent pain at the surgical site (15 cases), graft fracture or fragmentation (12 cases). (5) These results indicate that osteochondral allograft is an effective and safe substitute for knee joint transplantation. The overall success rate is 74% and the secondary operation rate is 17%. It is a treatment with high success rate and low risk of reoperation.

Conventional medical therapies have not been very successful in treating adults with refractory septic shock. The effects of direct hemoperfusion using polymyxin B and veno-arterial extracorporeal membrane oxygenation (ECMO) for refractory septic shock remain uncertain. A 66-year-old man was admitted to the emergency department and suffered from sepsis-induced hemodynamic collapse. For hemodynamic improvement, we performed direct hemoperfusion using polymyxin B. Computed tomography scan of this patient revealed emphysematous pyelonephritis (EPN), for which he underwent emergent nephrectomy with veno-arterial ECMO support. To the best of our knowledge, this is the first report of successful treatment of EPN with refractory septic shock using polymyxin B hemoperfusion and nephrectomy under the support of ECMO.
Adult ; Aged ; Emergency Service, Hospital ; Endotoxins ; Extracorporeal Membrane Oxygenation* ; Hemodynamics ; Hemoperfusion ; Humans ; Nephrectomy* ; Polymyxin B ; Pyelonephritis ; Shock, Septic*

A relationship between preceding acute paralytic poliomyelitis and the later development of motor neuron disease has only occasionally been suggested since it was first postulated by Charcot in 1875. The authors recently experienced a 20-year-old male who was considered to have postpoliomyelitis muscular atrophy. We report this case in view of its rarity and necessity of differential diagnosis from other neuromuscular disorders. Clinical presentation included slowly progressive muscle wasting of left thigh for 4 years, mild weakness of left arm and both thigh, intermittent fasciculation, and previous history of acute paralytic poliomyelitis. Electromyographic findings showed fibrillation potentials, positive sharp waves, fasciculations, giant motor unit potentials and reduced interference patterns. Muscle biopsy revealed scattered small angulated fibers, individual myofiber degeneration and mild inflammatory cell infiltration.
Arm ; Biopsy ; Diagnosis, Differential ; Fasciculation ; Humans ; Male ; Motor Neuron Disease ; Poliomyelitis ; Postpoliomyelitis Syndrome* ; Thigh ; Young Adult

Evaluations of residual renal function and the therapeutic effectiveness in renal tuberculosis have largely been dependent on intravenous pyelogram or Contrast-CT scan, even though, exact renal function are not evaluated with there methads. 99mTc-DMSA is a radiopharmaceutical that is trapped in the functioning tubular cells of the kidney and therefore, quantitative renal function could be evaluoted by ineasuring the counts of renal radioactivity and concomittant evaluation of renal morphology could be passible with the analog imapes of the radioactivity. The authors retrospectively analyzed 99mTc-DMSA scans of 75 kidndys of 67 patients with confirmed renal tuberculosis. We classified the morphologies of tuberculous kidneys as 6 types. We classified the morphologies of tuberculous kidneys as 6 types such as the type with small cortical defect, with parenchymal ulcerocavernous lesions, ulcerocavernous fistula to pelvis, mass-like defects, contracted kidney with ureter visualization, and the type with nonvisualization of kidney, corresponding to the characters of renal tuberculous pathogenesis with abscess formation, ulcerocavernous fistula, and fibrosis, and correspondings to the renal anatomy with parenchyma, and pelvocalyceal collecting system. Their mean residual renal functions measured with 99mTc-DMSA uptake rates were 19.0%, 18.4%, 7.9%, 12%, 4.1%, 3.4% respectively.
Abscess ; Fibrosis ; Fistula ; Fluspirilene ; Humans ; Kidney ; Pelvis ; Radioactivity ; Retrospective Studies ; Succimer* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Tuberculosis, Renal* ; Ureter

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (extranodal MZL) is a distinct subgroup of non-Hodgkin's lymphoma. Pulmonary extranodal MZL is a rare entity and accounts for less than 0.5% of primary pulmonary malignancies. Only a few cases of simultaneous occurrence of lung cancer and pulmonary extranodal MZL have been reported. A 60-year-old woman was referred to our hospital with a pulmonary nodule. She was diagnosed with lung adenocarcinoma by percutaneous needle biopsy. The protrusions into the left main bronchus were found by accident while performing bronchoscopy during lung cancer evaluation. The bronchial lesions were diagnosed as extranodal MZL. Although the patient underwent surgical resection for the lung adenocarcinoma, the pulmonary extranodal MZL was left untreated; it was monitored during follow-up visits. To our knowledge, this is the first report of synchronous lung adenocarcinoma and primary extranodal MZL of the main bronchus.
Adenocarcinoma ; Biopsy, Needle ; Bronchi ; Bronchoscopy ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Middle Aged

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type (extranodal MZL) is a distinct subgroup of non-Hodgkin's lymphoma. Pulmonary extranodal MZL is a rare entity and accounts for less than 0.5% of primary pulmonary malignancies. Only a few cases of simultaneous occurrence of lung cancer and pulmonary extranodal MZL have been reported. A 60-year-old woman was referred to our hospital with a pulmonary nodule. She was diagnosed with lung adenocarcinoma by percutaneous needle biopsy. The protrusions into the left main bronchus were found by accident while performing bronchoscopy during lung cancer evaluation. The bronchial lesions were diagnosed as extranodal MZL. Although the patient underwent surgical resection for the lung adenocarcinoma, the pulmonary extranodal MZL was left untreated; it was monitored during follow-up visits. To our knowledge, this is the first report of synchronous lung adenocarcinoma and primary extranodal MZL of the main bronchus.
Adenocarcinoma ; Biopsy, Needle ; Bronchi ; Bronchoscopy ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Middle Aged

Pulmonary metastasis occurs frequently in patients with gestational choriocarcinoma and most of these patients achieve remission with chemotherapy alone. Thus, the indications for surgical intervention are limited, but in appropriately selected patients, resection of a chemotherapy-resistant lung lesion can be curative. We have experienced that pulmonary metastatic choriocarcinoma in a drug-resistant patient was cured by pulmonary resection. So we report this case with a brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Pregnancy