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 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 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 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 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

OBJECTIVE To study the methods of surgical and prostheses repair of the defects after resection of the malignant maxillary sinus tumors.METHODS In 60 cases with malignant maxillary sinus tumors,surgical defects of 18 cases were repaired by pedicle forehead flaps,sternocleidomastoid myocutaneous flap,temporalis myofascial flap,pectoralis major myocutaneous flaps or palate flaps,and the surgical defects of 50 cases were repaired with maxillary obturator prostheses.RESULTS The postoperative speaking,swallowing,respiratory function and facial appearance recovered well in 68.3% cases,not well in 20% cases,poorly in 11.7% cases.There were 3 cases with wound split,1 case with necrosis of the margin of pectoralis major myocutaneous flaps and 3 cases with cutaneous fistula in inner canthus,and 8 cases with difficulty of opening mouth after operation.CONCLUSION Surgical reconstruction and obturator prostheses are the simple and economic methods for repair the defects after resection of the malignant maxillary sinus tumors.The proper fixation of prostheses and close the defects completely are the keys to recover the functions and facial appearance.

Objective To study the immune protective effects of liver graft on intestinal graft in simultaneous liver/small bowel transplantation. Method Rat models(Wistar to SD) of liver/small bowel transplantation(LSBTx),single liver transplantation(LTx)and single small bowel transplantation(SBTx) were established respectively. Twelve recipients from each group were used to determine survival time. Six recipients from each group were sacrificed for liver and/or small bowel biopsy at posttransplantation day 5,7 and 14,respectively. Rejections were detected by histopathology and mRNA expression of IL-2,IL-4,perforin and granzyme B in grafts by semi-quantitative reverse transcript PCR. Result The survival time of LSBTx recipients was (27.83?4.47) d,much longer than SBTx recipients (11.58?3.26) d,but was similar to LTx recipients (28.92?2.39) d. Allograft rejections of intestinal graft in LSBTx group were milder than that in STBx group,accompanied by down-regulated mRNA expression of perforin and granzyme B. Conclusion Simultaneous liver/small bowel transplantation in rats provides immune protection on intestinal graft.

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.