Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Vessels ; injuries ; Child ; Child, Preschool ; Female ; Free Tissue Flaps ; blood supply ; Head ; surgery ; Humans ; Male ; Middle Aged ; Neck ; surgery ; Tissue Transplantation ; adverse effects ; methods ; Young Adult

Objective: To analyze the value and reliability of combined free fibula flap and radial forearm flap in the reconstruction of extensive composite oro-mandibular defects. Methods: Extensive composite oro-mandibular defects were reconstructed in 23 consecutive cases (averagely aged 52.9 years old) with combined free fibula flap and radial forearm flap from March 2000 to January 2002. Data concerning the operation, defect description and site, recipient vessel and complications were reviewed. Results: The overall flap survival rate was 100% (all of 46 flaps) without partial or total flap necrosis. The overall complication rate was 30.4%. The vessel thrombosis rate was 2.2%, and the flap salvage rate was 100%. Conclusion: In selected cases, combined free fibula flap and radial forearm flap method may provide satisfactory reconstruction for extensive oro-mandibular defect, and greatly improve the quality of life of patients.

Objectives To find out the effects of estrogen and clomiphene on behavior of epileptic rats induced by kainic acid (KA) and probe into some mechanisms. Methods Ovariectomized Sprague-Dawley female rats were treated with estrogen (E) or estrogen and clomiphene (C). Their behaviors when they were induced seizures were observed and compared. Indirect immunofluorescence method was used to measure the alterations of gamma-aminobutyric acid (GABA) immunoreactive cells and ?1 subunits of GABA_A receptors in the hippocampus of all groups. Results The latency and time at reaching 4/5 degrees in KA+E group ((24.63?11.44) minutes and (41.50?16.22) minutes, respectively) were reduced greatly than KA group ((46.75?14.61) minutes and (65.13?12.99) minutes), while the latency of (KA+)E+C group (adding estrogen and clomiphene, (43.50?5.75) minutes) became prolonged significantly than in KA+E group. Conclusion High-level estrogen should be proconvulsant and the clomiphene might have some antiepileptic effects, which may be related with some alterations of GABA energic function in the brain.

[Objective]To compare two preparing procedures for larger chemically acellular nerve allografts (CANA). [Methods]The sciatic nerves of pigs were exposed by a muscle-splitting incision and were isolated free of the underlying fascia. The 60-mm-long segments of the nerve were obtained. They were treated according to the following decellularization processes.In group I,the nerve segments were treated with 7% Triton-100 solution and 7% sodium deoxycholate for two times.In group II,another protocol was created with the detergents Triton X-200,sulfobetaine-16,and sulfobetaine-10 for two times. The degrees of decellularization,activity of laminin,degrees of demyelination,and integrity of the nerve fiber tube were observed under microscope and were assessed by a scoring system.[Results]In both experimental groups the activity of laminin was present and the degrees of decellularization were complete. As for the demyelization of the nerve segments,the myelin sheath in Group II was partially preserved,but it completely disappeared in Group Ⅰ. The structure of the nerve fiber tube in Groups Ⅰ and Ⅱ were not as integral as that in the normal group.[Conclusion]It may be a better method for the larger CANA,to be treated with TritonX-100 and sodium deoxycholate during the decellularization procedure.

Adult ; Ear Protective Devices ; Female ; Hearing Loss ; prevention & control ; Humans ; Male ; Middle Aged ; Noise, Occupational ; adverse effects ; Occupational Diseases ; prevention & control

OBJECTIVEThe paper reviewed the effectiveness and reliability of skin paddles of free fibula flaps in the reconstruction of maxillofacial defects.

METHODSFifty-five consecutive free fibula osteocutaneous flap transfers performed from June 21, 1999 to October 31, 2000 were reviewed. The skin paddles of each flap were analyzed in terms of surgical design, blood supply, size, reconstruction location, and survival.

RESULTSFifty-seven skin paddles were used for the 55 free fibula flaps (double skin paddles for 2 flaps), 37 were nurtured by one perforator, 18 by two and two by 3 perforators. Twenty-eight skin paddles were used for intraoral reconstruction, 7 for extraoral reconstruction, 1 for both intraoral and extraoral reconstruction, 2 for soft tissue augmentation, and the remaining 19 were simply used as window for monitoring the blood flow of fibula flap. One free fibula flap with one skin paddle was lost because of venous thrombosis, and the other 54 flaps survived completely, with 100% survival of 56 skin paddles.

CONCLUSIONThe skin paddle of free fibula flap is safe and reliable. It can be used for all kinds of soft tissue reconstruction, as well as window for monitoring the blood flow of fibula flap after operation.

Adolescent ; Adult ; Aged ; Child ; Female ; Fibula ; Humans ; Male ; Mandible ; surgery ; Mandibular Neoplasms ; pathology ; surgery ; Microsurgery ; Middle Aged ; Mouth Neoplasms ; pathology ; surgery ; Oral Surgical Procedures ; methods ; Postoperative Complications ; surgery ; Reconstructive Surgical Procedures ; methods ; Reoperation ; Skin Transplantation ; Surgical Flaps ; blood supply ; Tissue and Organ Harvesting ; methods

Objective To compare the real time diagnosis and treatment values of magnifying endoscopy and electronic colonoscopy Methods A total of 105 colorectal polyps for colonoscopic examination were included in this study A magnifying videoscope with zoom ranges from ?1 to ?100 magnification and a common electronic endoscopy combined with indigocarmine dye were employed to observe the pit patterns of colorectal polyps Pit patterns were analyzed according to Kudo's modified classification as follows: ①type Ⅰ: round pit; ②type Ⅱ: asteroid pit; ③type Ⅲs: tubular or round pit, which is smaller than a normal pit (type Ⅰ); ④type ⅢL: tubular or round pit, which is larger than a normal pit (type Ⅰ); ⑤type Ⅳ: dendritic or gyrus like pit; ⑥type Ⅴ: irregular or amorphous pit; and ⑦ mixed type Results Magnifying colonoscopy revealed that phenotypes of non neoplastic and neoplastic lesions were 78 57% and 21 43% in inflammatory and hyperplastic polyps, 3 33% and 96 67% in neoplastic polyps, and 100% non neoplastic phenotype in juvenile polyps, respectively Pit pattern analysis according to Kudo's modified classification showed that the diagnostic sensitivity of neoplastic and non neoplastic lesions was 96 67% and 80%, and specificity was 86 57% and 94 73%, respectively The overall diagnostic accuracy in differentiating neoplastic from non neoplastic lesions was 89 52% Pit pattern by common electronic colonoscopy showed that the diagnostic sensitivity of neoplastic and non neoplastic lesions was 88 3% and 73 3%, and specificity was 81 5% and 82 5%, respectively The overall diagnostic accuracy in differentiating neoplastic from non neoplastic lesions was 82% Conclusion The pit pattern analysis of colorectal lesions by magnifying colonoscopy or electronic endoscopy combined with indigocarmine dye is a useful method for the identification of non neoplastic polyps, adenomas and invasive carcinomas in the large bowel Therefore, it may be possible to determine, at the time of colonoscopy, which lesions should be removed endoscopically and surgically

Selection of utilization of carbon source in soya oligosaccharide by three strains of S.cerevisiae was studied.The results showed that S.cerevisiae C could selectively utilize sucrose and the residual rate of stachyose and raffinose could be more than 96%.Using yeast extract as nitrogen source,the sucrose could be used up after 36 hours of culture.Further study showed that the content of sucrose in soya oligosaccharide powder was less than 1.3% after fermentation of waste water of soy whey and downstream processing.

Objective:To investigate the possibility of predicting facial nerve involvement in the pa-tients with parotid tumors using facial electroneurography (ENoG).Methods:In the study, 53 patients with primary parotid tumors were included in the study , 28 were benign tumors and 25 were malignant . There was no significant difference of tumor locations and sizes between the two groups . House-Brackmann facial nerve function evaluation was gradeⅠin all the patients who received examination of fa-cial electroneurography , including stimulation strength , amplitude , and latent time bilaterally .The facial electroneurography results in the affected side were compared with the results of contralateral normal side , intraoperative appearance and postoperative histopathological diagnosis .The facial electroneurography results were analyzed by Wilcoxon signed rank test and receiver operator characteristic ( ROC) curve. Results:During the facial electroneurography examination , the mean stimulation strength in the patients with benign parotid tumor was 20.0 mA.There was significant decrease in the amplitude at the affected side compared with the normal side upon posterior auricular stimulation ( P<0 .05 ) .But there was no significant difference in the latent time between the bilateral sides (P>0.05).However, in the patients with malignant parotid tumor , the mean stimulation strength was higher at 24.5 mA.There was signifi-cant decrease in the amplitude or even no response at the affected side compared to the normal side upon posterior auricular stimulation ( P<0 .05 ) .No response was detected in the multiple branches of facial nerve of affected sides in 36 .0%patients upon posterior auricular stimulation .The amplitude of branchesⅢand Ⅳwas significantly lower at the affected side than that at the normal side upon anterior auricular stimulation (P<0.05).The area under the ROC curve for ENoG was 0.884.Conclusion: When the facial nerve was involved by the parotid tumors , the stimulation strength in the electroneurography was larger .There was significant difference in the amplitude and the latent time of the facial nerve between the affected side and the normal side upon the posterior auricular stimulation .The rate of absence of reac-tion wave was higher in the patients with malignant tumors .It was feasible to predict the facial nerve in-volvement by ENoG for the parotid gland tumor patients without clinical appearances of facial paralysis .

Objective To investigate se rum concentration of tumor necrosis factor(TNF)-? and its correlation with insulin resistance in pregnant women with gestational diabetes mellitus (GDM). Methods Enzyme-linked immunosorbent assay was used to measure th e fasting serum TNF-? levels of 42 women with GDM (28～39 gestational weeks), a n d 40 cases of normal pregnant women in the third trimester. Fasting plasma gluc ose, insulin, C-peptide and glycosylated hemoglobin (HbA1c) were also measured at the same time. Insulin sensitive index (ISI) was calculated. Res u lts (1)Significantly elevated serum TNF-? was found in the women w i th GDM(5.2?1.6) ng/L as compared with the healthy pregnant women in third t rimester (4.5?0.5)ng/L(P