Objective To explore the microsurgical skills and clinical value of transorbitozygomatic approach for cavernous sinus tumors. Methods A retrospective research was given to 19 patients with cavernous sinus tumors microsurgically treated by transorbitozygomatic approach.Their tumors pathological types,clinic symptoms,characteristic images,surgical approach,surgical skills and postoperative complications were systemically analyzed. Results Total removal of the tumor was achieved in 17 cases and subtotal removal in 2 cases.38 percent of cranial nerves deficit was improved,43 percent of cranial nerves symptoms did not change,and 19 percent of cranial nerves palsies worsened.New cranial nerves symptoms occurred in 5 cases.No other severe complications or death occurred in all cases. Conclusion Transorbitozygomatic approach can preferably expose and totally resect cavernous sinus tumors.Knowing macro-micro anatomy of this approach,understanding the pathological-anatomic relationships betweem tumor and cavernous sinus,having practiced microsurgical skills are the linchpins to resect the tumor totally and protect cranial nerves effectivctively.

Objective:To explore the roentgenographic and biomechanical characters of distraction osteogenesis(DO) in the treatment of mandibular defect.Methods:4 beagle dogs were used to establish 2.0 cm mandibular defect model,after 6 months, a 1.5 cm transport disc was surgically created adjacent to the defect area in an intraoral way, and intraoral device was placed on the transport disc and the base bone segments.A reconstructive plate was applied to stabilize the bone segments. After a 10 day latency period, the transport disc was advanced at a rate of 0.5 mm ? 2/day until the bone fragments were docked at the planned position.35 weeks after completion of distraction the animals were sacrificed,specimen retrieval,roentgenography and the stress testing were performed.Results:The regenerated segments were comparable with the corresponding segments of native mandible,and exact location of junction between the regerated and preexisting bone could not be determined easily. Roentgenographic revealed that the defects were reconstructed with outer cortical layer and trabecular medullary cavity of the bone.The regenerated segments remained less radiodense than the native mandible.Stress test demonstrated that the average ultimate strength of regenerated segmens was (69.4?19.2) MPa,that of the corresponding normal mandible was (86.9?31.9) MPa,and that of junction between transport disc and base bone was(46.9?8.4) MPa. Conclusion:Intraoral distraction osteogenesis may be feasible in the treatment of mandibular defect.

Objective To explore clinical curative effect of microsurgery of petroclival tumors by transpetrosal presigmoid approach. Methods A series of 23 patients of petroclival tumors resected by microneurosurgery were analyzed retrospectively, including tumors histological types, clinical and preoperative MRI features, operative approaches, surgical technique and common postoperative complications. Results Total resection of the tumor was achieved microsurgically in 16 cases, subtotal resection in 4 cases, partial resection in 3 cases. No patient died in this series. 8 patients presented worsening crainal nerves palsies postoperatively. CSF leaks were uncommon, occuring in 2 patients. Conclusion The tumors in petroclival region can be totally resected by transpetrosal presigmoid approach. The advantages were offered by this approach such as the temporal lobes and cerebellum are minimally retracted; the operative distance of petroclival tumors is shortened with exposure of clivus and juxta-clival region.

Objective:To describe the application of intraoral di st raction osteogenesis for correction of maxillofacial and mandibular deformities . Methods: 5 cases with serious maxillofacial or mandibula r deformities underwent distraction by using 2 types of intraoral distraction d evice.Mandibular lengthening and maxillary widening for micrognathia and maxilla ty constriction was performed in 1 case with Treacher Collions syndromes. M axillary distraction osteogenesis for maxillary hypoplasia in 2 cases.Simultaneo us maxillary and mandibular distraction in 1 case with hemifacial microsomia. T ransport distraction for mandibular body rectangle defect in 1 case. Results: Satisfactory morphologic results were achieved in all patients with good facial symmetry, ad equate occlusal relationship without any complication.Conclusions: Intraoral distraction osteogenesis provides a safe and effective treatment for the reconstruction of facial morphologic and occlusal relationshi p.

Objective:To study the ultrastructural characters and mineral content of the newly formed bone induced by distraction osteogenesis(DO) in the canine mandibular defects.Methods:4 beagle canines were used to establish 2.0 cm segmental mandibular defect surgically. Intraoral bifocal distraction osteogenesis was used to repaire the defects. After a 10-day latency, the transport disc was advanced at a rate of 0.5 mm? 2/day until the bone fragment was docked at the planned position. Specimen retrieval at 35 weeks after completion of distraction, scanning electron microscopy(SEM) analysis was then performed. The mineral content was measured by electron dispersive spectroscopy.Results:35 weeks after application of DO the mandibular defects were completely filled with regenerated bone. The regenerated bone was compact, sturdy and mature. The new bone was closed to the transport disk. The Ca/P content ratio was 1.80 in the regenerated bone and 2.02 in the transport disk.Conclusion: DO may induce new bone formation and may be used to repaire mandibular defects.

Objective To explore the correlation between left ventricular hypertrophy (LVH) and dynamic parameters of blood pressure as well as blood pressure variation in patients with essential hypertension (EH). Methods From January to September, 2013, 581 patients with EH were divided into hypertrophy group (n=161) and non-hypertrophy group (n=420) according to the left ventricular mass index (LV-MI). The clinical data, biochemical indexes and dynamic parameters of blood pressure were compared, and the multiple factors regression was used to analyze the risk factors of LVH. Results The incidence of LVH was higher in women than in men (χ2=4.836, P=0.03), the level of blood uric acid was higher in the hypertrophy group than in the non-hypertrophy group (t=-11.540, P<0.001). The clinic systolic blood pressure was higher in the non-hypertrophy group (t=-3.805, P<0.001). There was significantly difference in 24-hour systolic blood pres-sure load, systolic blood pressure drops at night and average systolic blood pressure between two groups (t>2.770, P<0.05). Multi-factor Lo-gistic regression analysis showed that gender (OR=1.674, P=0.044) and 24-hour systolic blood pressure load (OR=1.021, P=0.003) associat-ed with LVH. Conclusion The occurrence of LVH in patients with EH was closely related to the 24-hour systolic blood pressure load, and was higher in women than in men.

Objective:To investigate the effect of the ceramometal b ridge on the local gingival groove flora.Methods: Classi cal bacterial incubation and identification were used to study the changes of th e local gingival groove flora in 6 patients wearing ceramometal bridge for 1 wee k to 3 months. Results: 3 months after the prosthetic procedure the CFU o f P.melaninogenica, Gram-positive bacilli cmainly Actinomyces and the t otal bacteria were significantly increased (P

Adult ; Empyema, Pleural ; complications ; etiology ; Humans ; Male ; Neck Injuries ; complications ; Tracheoesophageal Fistula ; complications ; etiology

BACKGROUND: A stable and exact animal model is the necessary tool and basis for studying hemorrhagic cerebrovascular diseases.OBJECTIVE: To establish and evaluate the intracerebral capsular hemorrhage models in rats.DESIGN: A randomized and controlled animal experiment.SETTING: Second Hospital Affiliated to Xuzhou Medical College; First Hospital Affiliated to Nanjing Medical University.MATERIALS: This experiment was carried out in the animal experimental center of Nanjing Medical University during May to November 2002.Totally 35 SD rats were randomized into two groups: experimental group (n=30) and sham-operation group (n=5).METHODS: ① Autoblood was injected into the intracerebral capsule of rats to create intracerebral capsule hemorrhage models with stereotaxy in the experiment group. ②Scoring was conducted according to 5-point neurological scoring criteria from ZeaLonga, somatic sensation and motor function of rats were observed. ③Somatosensory evoked potential(SEP) of rats was detected pre- and post-operation under anesthetic state. ④ After determination of SEP, the rats were sacrificed under anesthetic state. Brains were taken out to made slices, then sections were stained with haematoxylin and eosin. Changes in haematoma and histomorphology were observed at the largest focus under optical microscope.MAIN OUTCOME MEASURES: ①Nerve function scoring; ②Latent period of various waves of SEP; ③ Observation of brain tissue morphology.RESULTS: Totally 35 rats entered the stage of result analysis. ①Appearance of obvious paralysis of the rats suggested the modeling was successful. The successful rate of this experiment was 93.3%(28/30). Significant difference existed in neurological scoring between experimental group [(2.74±0.46)points] and sham-operation group (0 point)(P＜0.05). ②SEP showed that the latent periods of various waves of experimental group after operation were significantly delayed than those before operation and those of sham-operation group [P1: (15.72±0.78) ms, (10.69±0.52) ms, (10.73±0.48) ms;Nl: (17.95±1.27) ms,(13.21±1.31) ms, (13.34±1.27) ms;N2:(21.16±1.62) ms, (15.42±1.46) ms,(15.58±1.44) ms;N3:(24.86±1.58) ms, (18.72±1.76) ms, (18.99±1.67) ms,P＜0.05]. ③In the shamoperation group, a few red blood cells were scattered in the peripheral area of needle channel were found, but hemorrhagic focus was not; In the experimental group, irregular or oval blood clots presented in the left internal capsule area. In about a low-fold visual field, brain tissue in the surrounding of hemorrhagic focus was loosened and swelled, and pathological changes were obviously severer than those in the sham-operation group.CONCLUSION: Intracerebral capsular hemorrhage induced by injection of autoblood with stereotaxy is more close to clinical situation, and it is easy to operate and has good reproducibility.

ObjectiveTo investigate the relationship between the oxidative injury induced by low glucose and mitochondrial membrane potential in HUVEC-12 cells. Methods Human umbilicalvein endothelial cells HUVEC-12 were cultured in low concentration glucose for 4 h.Cell viability of HUVEC-12 cell was assessed with MTT assay.Dihydroethidium (DHE) was used as a reactive oxygen species (ROS)capture, which was detected the mean fluorescence intensity of samples and Rhodamine 123 as a fluorescence detector was to measure the level of mitochondrial membrane potential (MMP) in cells.Results Comparing to HUVEC-12 cells viability in 5.5 mmol/L glucose group (96.80 ±3.20)％, cells exposed to 2.8 mmol/L glucose group (66.40 ± 1.60) ％ and 0 mmol/L glucose group (58.93 ± 1.67) ％ were decreased by 32％ and 40％ respectively (P ＜ 0.01).ROS level of 5.5 mmoL/L glucose group, 2.8 mmol/L glucose group and 0 mmol/L glucose group were 0.59 ± 0.02, 0.74 ± 0.04 and 0.88 ± 0.05,respectivdy, increased by 25％ in cells exposed to 2.8 mmol/L glucose and by 48％ in cells without glucose exposure comparing to 5.5 mmol/L glucose group (P ＜0.01) ; MMP levels of 5.5 mmol/L glucose group,2.8 mmoL/L glucose group and 0 mmoL/L glucose group were 148.83 ± 3.51, 271.07 ± 19.54 and357.74 ±51.32 respectively, increased to 1.8 times in cells exposed to 2.8 mmol/L glucose and to 2.4times in cells without glucose exposure comparing to 5.5 mmoL/L glucose group (P ＜ 0.01).Conclusion Low glucose leads to injury in HUVEC-12 cells, which is probably induced by the oxidative stress via the increasing MMP.