Objective:To summarize the experience of reconstruction of mandibular defects with vascularized fibular osteocutaneous flap.Methods:Segmental mandibular resection and immediate reconstruction with vascularized fibular osteocutaneous flap were performed in 8 patients with tumor.The fibula flaps were cut into 2-4 segments and bent to the contour of the mandibles,and they were fixed precisely by the titanium plate.The skin flaps were used for reconstruction of soft tissue defects or as observation windows of the blood circulation.Results:In all 8 patients,transplanted vascularized fibular osteocutaneous flaps survived well,and restoration of mandibular contour and function was satisfactory. Conclusion:The fibular osteocutaneous flap can be cut into segments and shaped according to location and contour of mandibular defect.Vascularized fibular osteocutaneous flap may be an ideal selection for the reconstruction of mandibular defect.

AIM: To analyze the nucleotide and putative amino acid sequences of PIA genes isolated from N. gonorrhoeae and to construct the prokaryotic expression system of PIA gene.METHODS: The entire PIA genes from 9 strains of N. gonorrhoeae were amplified by using high fidelity PCR. The target amplification fragments were sequenced after T-A cloning. Homology comparison of the nucleotide and putative amino acid sequences of PIA genes from the isolates with the reported sequences in GenBank was then performed. A prokaryotic expression system of PIA gene was constructed. Different dosages of IPTG were applied to induce the expression of the target recombinant protein (rPIA) and 10% SDS-PAGE plus Bio-Rad Agarose Image Analysor was used to determine the expression level of rPIA. rPIA was extracted using Ni-NTA affinity chromatography and the purified effect was detected by SDS-PAGE.RESULTS: In comparison with the reported PIA gene sequences (GenBank No: L19962), the homologies of nucleotide and putative amino acid sequences of PIA genes from the isolates were 99.6%-100% and 99.1%-100%, respectively, which indicated that all the isolates were belonging to serovars IA6. Output of rPIA was as high as 50.1% of the total bacterial proteins. The purified rPIA only showed a single target protein fragment in gel.CONCLUSION: Serovar IA6 is dominant in the local N. gonorrhoeae isolates and sequences of the encoding gene are relatively conserved. The constructed prokaryotic expression system is able to express rPIA with high efficiency, which may lay a foundation for further development of serological detection kit and vaccine of N. gonorrhoeae.

Objective:To explore the effect of damage control surgery on polytraumatism with severe oral maxillo-facial trauma.Methods: We retrospectively analyzed 32 cases of polytraumatism with severe oral maxillo-facial trauma treated by damage control surgery.Results: The principles of damage control surgery were successfully applied to the treatment.Of the 32 cases,31 survived,with their polytraumatism sequentially managed,and only 1 died.Conclusion: Damage control surgery helps to raise the success rate in the treatment of polytraumatism with severe oral maxillo-facial trauma.

By combining coral with recombinant human bone morphogenetic protein-2 (rhBMP-2), rhBMP-2/coral composite was obtained in this study. Following implantation of the composite into the muscle pouches of mice, cartilage growth was induced in the pores or on the surface of the implants at one week, woven bone at three week and lamellar bone with bone marrow at six week, and coral was absorbed partially. The induced formation of endochondral bone was time-related and rhBMP-2 dose-related. The results of this study indicate that the composite possesses a superior ability of osteogenesis, and coral acts as one of the most suitable rhBMP-2 slowrelease carriers currently available. The composite will be a new type of bone substitute to be used in orthopaedics and maxillofacial surgery.

OBJECTIVETo investigate the physicochemical constants such as equilibrium solubility and apparent partition coefficients (Papp), and study the effects of temperature, pH value and antioxidants on the stability of breviscapine solution.

METHODThe equilibrium solubility of breviscapine in various medium and the Papp of breviscapine under different pH conditions were determinated by RP-HPLC, and the effects of temperature, pH value and antioxidants on the stability of solution were investigated by taking change rates of drug content in 10 h as detection index.

RESULTThe equilibrium solubility of breviscapine in saline, distilled water, pH 7.0 PBS, pH 7.5 PBS, Ringer's fluid, methanol and ethanol were (20.68 +/- 1.12), (79.35 +/- 0.68), (7954.62 +/- 34.90), (18,708.17 +/- 253.05), (3670.40 +/- 27.64), (210.71 +/- 0.74), (184.34 +/- 1.47) mg x L(-1) respectively; while in pH value 3.0, 4.0, 5.0, 6.5, 7.0 solution, the Papp were 5.362, 0.542, 0.371, 0.328 and 0.143 respectively. The stability of breviscapine in the Ringer's fluid was the worst and the stability was significantly decreased with the increase of temperature and pH value and it could be improved by EDTA-2Na.

CONCLUSIONThe established HPLC assay was accurate and convenient. The Papp of breviscapine is decreased by increased the pH value, while in the aqueous solution the equilibrium solubility of breviscapine increase with the pH in crese. EDTA-2Na can be used as an antioxidant of breviscapine solution.

Antioxidants ; chemistry ; Chemical Phenomena ; Drug Stability ; Edetic Acid ; chemistry ; Flavonoids ; chemistry ; Hydrogen-Ion Concentration ; Solutions ; Solvents ; chemistry ; Temperature

Medical professionalism is the perfect combination of medical science spirit, medical humanities spirit and professional spirit. As a special group in medical colleges and universities, medical interns should attract teachers' attention due to the occupational confusion caused by the epidemic. Taking the brave "countermarching people" as examples, establishing the correct value orientation, strengthening the study of professional expertise, building a trinity teaching system of medical professionalism, and exploring ESPCS (explain-simulate-practice-communication-support) practice teaching are effective measures to reshape the professionalism of medical interns.

Objective: To investigate the resuscitation effect of aortic balloon occlusion (ABO) on the traumatic cardiac arrest (TCA) in swine. Methods: Twenty-seven male domestic swine weighing (32.7±3.8)kg were utilized. After 40% of estimated blood volume was removed within 20 minutes, the animals were subjected to 5 minutes of untreated ventricular fibrillation and then 5 minutes of cardiopulmonary resuscitation. Additionally, fluid resuscitation was initiated coincident with the beginning of cardiopulmonary resuscitation. The animals were randomly divided into model group (n=12) and ABO group (n=15). Once cardiopulmonary resuscitation was implemented, aortic balloon was concurrently inflated to stop the blood flow of descending thoracic aorta at the level of the diaphragm in the ABO group. In the model group, aortic balloon was placed in the same position without inflation. During cardiopulmonary resuscitation, the changes of coronary perfusion pressure (CPP), forehead's regional cerebral oxygen saturation (rSO₂) and pressure of end-tidal CO₂ (PETCO₂) were continuously monitored, and the rate of return of spontaneous circulation (ROSC), duration of cardiopulmonary resuscitation, number of shocks and dose of epinephrine were recorded. At 5 minutes after successful resuscitation, the levels of arterial blood gas, lactate and jugular venous blood oxygen saturation (SjvO₂) were measured. Results: Compared with the model group, the values of CPP, rSO₂ and PETCO₂ during cardiopulmonary resuscitation were significantly increased in the ABO group [CPP: (33.5±5.6)mmHg vs. (23.1±5.2)mmHg at 1 minute, (35.3±6.0)mmHg vs. (26.8±7.4)mmHg at 2 minutes, (36.3±6.3)mmHg vs. (28.2±6.3)mmHg at 3 minutes, (40.1±7.1)mmHg vs. (30.5±6.2)mmHg at 4 minutes, (38.1±7.5)mmHg vs. (29.8±5.3)mmHg at 5 minutes; rSO₂: (45.4±5.2)% vs. (39.2±5.1)% at 1 minute, (47.2±3.6)% vs. (42.0±6.4)% at 2 minutes, (47.7±3.0)% vs. (41.5±5.4)% at 3 minutes, (47.0±2.5)% vs. (42.1±5.9)% at 4 minutes, (47.1±2.0)% vs. (41.5±7.4)% at 5 minutes; PETCO₂: (17.0±3.5)mmHg vs. (12.7±4.2)mmHg at 1 minute, (18.5±3.7)mmHg vs. (14.5±2.7)mmHg at 2 minutes, (20.7±5.3)mmHg vs. (15.5±3.2)mmHg at 3 minutes, (18.7±4.5)mmHg vs. (14.9±3.5)mmHg at 4 minutes, (18.2±3.2)mmHg vs. (14.5±4.2)mmHg at 5 minutes] (all P<0.05). The rate of ROSC was significantly higher in the ABO group than in the model group[100%(15/15) vs. 75%(9/12)] (P<0.05). Additionally, shorter duration of cardiopulmonary resuscitation, less number of shocks and lower doses of epinephrine were observed in the ABO group when compared with the model group[duration of cardiopulmonary resuscitation: 5(5, 5)minutes vs. 5(5, 12.5)minutes, number of shocks: 1(1, 1)times vs. 1(1, 4)times, dose of epinephrine: 0.62(0.62, 0.74)mg vs. 0.64(0.59, 2.59)mg] (all P<0.05). At 5 minutes after resuscitation, the level of arterial lactate was significantly decreased and the value of SjvO₂ was significantly increased in the ABO group compared with the model group[Lactate: (9.6±0.8)mmol/L vs. (10.8±1.4)mmol/L; SjvO₂: (50.0±8.6)% vs. (37.9±16.3)%] (both P<0.05). Conclusions In a swine model of TCA, ABO can increase cardiac and cerebral perfusion during cardiopulmonary resuscitation and improve the efficacy of cardiopulmonary resuscitation. It might provide a novel and effective method for the resuscitation of TCA in the clinical setting.