砄bjective:To study the effects of superlong pedicled latissimus dorsi muscle transplantation (SPLDMT) in the treatment of facial paralysis.Method: 16 cases of unilateral long standing facial paralysis were treated with SPLDMT in 1991～1998;follow up was conducted and the effects were analysed. Results:After operation satisfied movement recovery of the facial muscles was observed in 12 and improvenent in 3 of the 16 patients,no change was found in only 1 case. Conclusion: SPLDMT is effective in the treatment of unilateral long standing facial paralysis.

Objective:To evaluate functional recovery of nerve and muscle after end-to-side neurorrhaphy.Methods:10 SD rats were randomly and evenly devided into group A and group B.Right common peroneal nerve was amputated in all the rats.Then the distal stump was sutured to the ipsilateral tibial nerve by the end-to-side way through a epineurial window in group A. The right common peroneal nerve was severed in group B as denervated control.After 1.5 months all the rats were subjected to walking track analysis,histological and ultrastructure observation.Results:In group A peroneal nerve index (PFI) achieved -41.634,density of collateral axons 51.437?12.041/1 000 ?m 2,synapsin (SYP) 439?120.5.In group B PFI was -100,SYP 0. In normal control PFI was 0, density of collateral axons 18.847?1.078/1 000 ?m 2,SYP 842?84.7.Conclusion:End-to-side neurorrhaphy may induce nerve sprout plenty of collateral axons.The axons can reach target muscle to reconstruct functional neuromuscular junction,and recover the function of the muscle in some degree.

Objective:To evaluate the effect of iliac bone graft and radial forearm flap in the reconstrucion of maxilla.Methods:Maxilla defects were reconstructed using iliac bone graft and radial forearm flap in 4 patients.The effects were evaluated clinicaly.Results:In all the 4 cases,palatal defects resulted from maxillectomy were optimally reconstructed with non-vascularized iliac graft and radial forearm flap.The masticatory function of the upper jaw,intelligible speech,swallow and natural facial appearance were recovered.As a result,quality of life of the patients was improved.Conclusion:Iliac bone graft and radial forearm are feasible in the reconstruction of maxilla defects.

To evaluate the incidence of sub-clinical neck metastasis and its surgical treatment in patients with oral squamous cell carcinoma (OSCC) without clear evidences for lymph nodes metastasis, a total of 205 patients with OSCC in N0 and N1 stage(UICC 1987′s classification) were included in the study.Their clinical and histopathological files were retrospectively studied and patients were followed up after operation. Histopathological positive lymph nodes were found in 10.8%(13/120) of patients,and postoperative lymph nodes metastasis occurred in 16.5%(14/85) of patients without neck dissections.There were no significant differences between N0 and N1 groups.Neck recurrence occurred in 11.9%(5/42) of patients after functional neck dissections.The rate was higher in patients with bucal lesions.Patients undergoing radical neck dissections also had neck recurrence with an incidence of 6.4%.But most of them occurred on contralateral side. It suggested that subclinical metastasis of OSCC with clinically negative neck lymph nodes could not be neglected.Functional neck dissection should include the lymph nodes of level Ⅲ,especially for cancers located on bucca mucosa and tongue.Bilateral neck dissection is necessary for large primary lesions spreading to the contralateral side.

Objectives: To study the treatment outcome of mucoepidermoid carcinoma(MEC).Methods:128 cases of MEC with definite pathologic diagnosis treated in our hospital during the past 15 years were investigated. The relationship between the effects of the therapy and the prognosis was analysed.Result:Treatment with surgical operation only was used in 99 cases,radiotherapy after operation was applied in 26 cases and follow-up was carried out in 76 cases. 5-year survival rate was 90.7%.5 patients who died within 5 years after operation were all with the diagnosis of MEC in clinical stage Ⅳand poor differentiaton.Conclusion:The local extensive excision for the well differentiated MEC,the radiotherapy after operation for poorly differentiated or that of clinical stage Ⅳ,especially in maxilla,may increase 5-year survival rate.Since there were cases of recurrences of MEC 13 years after surgical treatment,long-term follow-up is necessary.

?Objective: To study the methodology of the culture of Schwann cells derived from degenerated peripheral nerve. Method: Sciatic nerve of adult rats was surgically cut. 14 days after operation, the degenerated nerve tissue was obtained and treated with trypsin and collagenase typeⅡ to prepare single cell suspension,the cells were purified by different speed of attachment and digestion, and incubated on ZQ membrane in the presence of 10 -5 mol/L cytosine arabinoside. The growth of the cells of passage 2 was studied by MTT assay. Schwann cells were identified with anti S100 immumohistochemistry. Results: The cultured cells were spindly in shape and 95% of them were S100 positive. The population doubling time of passage 2 cells was 72 h.The cells attached and stretched on ZQ membrane as well as on the culture vessel surface. Conclusion: Schwann cells can be cultured and purified by predegeneration of the peripheral nerve,different speed of attachment and digestion and the presence of cytosine arabinoside. The cells can grow well on ZQ membrane.

Objective: To sammarize the methodology of the treatment of alveolar cleft by autogenous cancellous bone graft obtained with mini incision(ABGM).Methods: 22 cases of alveolar cleft received ABGM by one operator. The cleft area was restored with autogenous cancellous bone from iliac crest by cylinder osteotomes for extraction of bone transplants(COEBT) with mini incision. All the patients were follow up for at least six months postoperatively. The result of the bone grafting was evaluated on the radiographs. Results: ①The overall survival rate of ABGM was 95.8%,and clinical successful rate was 91.7%;②The successful rate of ABGM in group of patients above 18 year old, or with complete cleft palate or bilateral cleft lip and palate was lower than that in other groups.③The wound for extracting autogenous cancellous bone from iliac crest by COEBT with mini incision was smaller than that by osteotomy. Conclusion: ABGM with COEBT is an effective way in the treatment of alveolar cleft. The successful rate of ABGM is related with the age and cleft style of the patients.

Objective :To study the effects of NO precursor, L-arginine(L-Arg) and constitutive nitric oxide synthase(cNOS) inhibitor, L-nitroarginine(L-NNA)) on the expression of cNOS in facial nerve and surrounding tissues in traumatic facial paralysis rats. Methods:Facial paralysis was surgicaly created by impact in 57 SD rats. The rats were divided into 3 groups with 18 in each group, another 3 rats were used for morphological study. L-Arg at 40 mg/kg or L-NNA at 50 mg/kg were intraperitoneally injected into rats 2 times a day, from 4 days before untill 14 days after surgery(group L-Arg and group L-NNA). In control group(NS) same volume of normal saline was given to the rats after creation of facial paralysis. The facial nerve and surrounding tissue samples were obtained at different time. Immunohistochemical ABC method was used to examine cNOS and inducible NOS (iNOS) expression in facial nerve and surrounding tissues. Results:cNOS immunoreactivity was observed in traumatic facial nerve in L-Arg group 7 days after trauma and in the adjacent muscle in the 3 groups from 6 h to 3 d after trauma. iNOS was found in the paralyzed nerves from 1 d to 7 d after trauma in the 3 groups, and in the adjacent tissues from 6 h to 3 d after trauma in the 3 groups. Conclusions:L-Arg may stimulate constitutive NOS expression in facial nerve and probably promote the nerve regeneration.

[Objective]To establish 3D finite element model of adolescent idiopathic scoliosis.Stress analysis on established 3D finite element model was done to compare the specific quantity of stress among every vertebra.[Method]Under the help of related softwares,3D finite element model was established from CT scan of a adolescent idiopathic scoliosi.A number of points were chosen on the model.Stress analysis was done in normal loading.[Result]Vertebral wedging and stress distribution showed significant regularity.The result was the largest in the apical region,and showed a gradual decrease to the end vertebral.[Conclusion]Relative biomechanical and clinical analysis can be easily conducted on 3D finite element model of scoliosis.It is possible to analyze diversity of stress on different conditions.

砄bjective: To summarize the clinical characteristics of basal cell nevus syndrome (BCNS) and the treatment experience of cysts in jaws. Methods: 24 patients of BCNS from Mar. 1981 to Sept. 1999 were retrospectively investigated. Results: Of all the cases, the mean age for the first examination was 17 years old. The respective incidence of the main symptoms were multiple nevi in 9 cases (37.5%), palmar and/or plantar pits in 7 (29.2%), spine and/or ribs deformity in 17 (70.8%), intracranial calcification in 19 ( 79.2% ), specific facial profile in 16(66.7%). The cysts of jaws were the main causes for early examination, which were characterized by their multiple and preadolescent occurrences. The cysts were surgically removed and the postoperative recurrence rate of the cysts was 22.0%. Conclusion: Much attention should be paid to the cysts of jaws, the main symptoms, and cause of the physiological and psychological impairment in the patients of BCNS.