Objective To investigate the surgical correction of alar deformity and repairing function of unilateral cleft lip in infant. Methods Millards procedure was used to incise skin, muscle and mucosa, correct the nasal deformity through lip. At the normal side, ophthalmic scissors was applied to incise lips muscle and skin, and reach the deep level of the base of nasal pillor, cut the abnormal attachment between the orbicular muscle of mouth and anterior nasal spina, and sharp dissect cartilage and skin in nasal wing through deep level of nasal pillor. At the cleft side, the abnormal muscle branch was cut that attached at the down side of the base of nose and pyriform aperture, the tissue between nasal base and lip, maxilla relaxed, and the cartilage and skin in the nasal wing at the same side dissected. The deform cartilage was repairied as the same of normal side. After the rehabilitation of cartilage of nasal wing, the soft tissue at deep level was moved to normal location, but the deep level structure of nasal wing cartilage, nasal septum cartilage and nasal bone did not dissected. After the dissection of orbicular muscle of mouth, the muscle in nose and lip must be relaxed in illous side. The orbicular muscle of mouth was sewed under the condition of tensionless. The repairing of orbicular muscle of mouth will improve the balance of muscular strength around the nose. Thus, the deviation of nasal pillor was corrected and the base of nose repaired. Results Eighty cases of infant with unilateral cleft lip at the age of 3 months ～12 months, in which 11 cases were Ⅰ?,16 Ⅱ, and 3 Ⅲ?. Eighty cases were low grade alar deformity, and 13 middle grade deformity. After operation, 52 cases were better, 17 cases were good, and 11 cases were worse. The postoperational result was good. Conclusion While performing the cleft lip operation or Millard operation, the authors can correct the nasal deformity through lip. So, it is recommended that cleft lip and the alar deformity can be repaired at the same time.

Objective To observe the effects of recombinant human brain natriuretic peptide on the plasma endotoxin and systemic inflammatory response in patients undergoing cardiac valve replacement surgery during cardiopulmonary bypass (CPB) and to explore its mechanism.Methods 32 patients with elective heart valve replacement surgery during cardiopulmonary bypass were divided into a control group and a treatment group randomly.The patients of treatment group were recievel rhBN (1.5 μg · kg-1 · min-1 bolus intravenous injection before aortic cross-clamping followed by 0.0075 μg · kg-1 · min-1 for 24 hours),while the patients of control group received the same volume of 0.9％ sodium chloride.The plasma levels of endothelin -1 ( ET-1 ),diamine oxidase(DAO),lipopolysaccharide ( LPS),tumor necrosis factor-α (TNF-α) before skin incision ( T1 ),the end of CPB ( T2 ),4 h after the end of CPB ( T3 ),8 h after the end of CPB (T4),24h after the end of CPB (T5) respectively.Results Before skin incision ( T1 ),plasma ET-1,DAO,LPS,TNF-α of two group patients showed no significant difference ( P ＞ 0.05 ) ; At each time point after the end of CPB ( T2,T3,T4,T5 ) Plasma DAO,LPS,TNF-α levels of two groups patients were significantly higher than before skin incision ( T1 ) levels ( P ＜ 0.01 ).There was no significant difference of the plasma levels of ET-1 between T5 and T1 in treatment group patients ( P =0.24).At each time point after the end of CPB ( T2,T3,T4,T5 ),treatment group patients'plasma ET-1,DAO,LPS,TNF-α levels were significantly lower than the control group respectively (P ＜0.01 ).The increase in blood ET-1 was highly positive correlated with the increase in blood DAO (r=0.51,P ＜0.01 ).The increase in blood DAO was highly positive correlated with the increase in blood LPS (r =0.77,P ＜ 0.01 ).The increase in blood LPS was significantly positive correlated with the increase in blood TNF-α ( r =0.48,P ＜0.01 ).Conclusion Recombinant human brain natriuretic peptide can reduce gastrointestinal vasoconstriction,improve gastrointestinal mucosal perfusion and oxygenation,protect the gastrointestinal mucosal barrier function,preventing intestinal endotoxemia Shift,reduce plasma endotoxin levels and reduce systemic inflammatory response by inhibiting the release of ET-1 during CPB.

Objective The purpose of this study was to evaluate the outcome of autogenous bone grafts in unilateral cleft lip and palate patients following early orthodontic tooth movement,and to determine the volume of new bone formation in the bone grafted region with spiral computed tomography.Methods Computed tomography scans of 12 patients were taken immediately preoperatively and at 6 months postoperatively.The patients underwent bone grafting between 9 and 13 years of age were divided into two groups based on whether postoperative orthodontic tooth movement were initiated or not.Three-dimensional models were created in each period,and the defect of alveolar cleft and volume of the newly formed bone were calculated in each patient.The roots of the moved teeth and their positions to the alveolar bone were also observed.Results The preoperative cleft width and cleft volume were not significantly different between both groups.The volume of the newly formed bone in group A was (0.98±0.23) mm3,significantly higher than that in group B,which was (0.73± 0.15) mm3.The rate of newly formed bone in group A was (72.5 ± 11.9)％,significantly higher than that in group B,which was (53.2±9.7)％.The cleft adjacent teeth could move smoothly into the bone grated area,with no root resorption observed in the computed tomography scans.Conclusions Early orthodontic tooth movement can reduce bone resorption in autogenous bone grafted unilateral cleft lip and palate patients through the observation of spiral computed tomography.It plays an active role in the bone remolding process after bone grafting.

Objective To observe the effect of Chinese herbal compound Tangbikang on the level of plasma β-EP of diabetic peripheral neuropathy rats, and to discuss its mechanism of neuroprotection and abirritation. Methods STZ and feeding high fat forage induced diabetic rats were randomly divided into diabetic model group, Mecobalamin group, Tangbikang high dose group, Tangbikang medium dose group, Tangbikang low dose group, with 10 normal rats as control. The control group and model group were daily gavaged with distilled water, Tangbikang groups were given Tangbikang with different dose. Mecobalamin was used as the control medicine. Body weight and FBG was detected every 4 weeks, rats’ unilateral sciatic nerve were taken out at the 16th week. Pathological variation of sciatic nerve was presented by HE staining, and radioimmunoassay method was used to detect the levels of plasma β-EP of diabetic peripheral neuropathy of rats. Results The weight and FBG had obviously changed in the 16th week. Compared with the model group, pathological injury of diabetic peripheral neuropathy rats in the Tangbikang groups were significantly improved. The level ofβ-EP of model group was significantly decreased (P<0.01) compared with normal group. Tangbikang medium and high dose group significantly increased the level of plasma β-EP (P<0.01). Conclusion Chinese herbal compound Tangbikang could reduce the fasting blood glucose, protect nervous system and promote the level of plasmaβ-EP of diabetic peripheral neuropathy rats.

Traditional Chinese medicine (TCM) is an important part of the overall strategy of "Belt and Road",special resources and national advantages.In the face of the "Belt and Road" strategy to the internationalization of Chinese medicine brought an excellent opportunity.This paper proposed the important TCM treatment principle of syndrome differentiation and treatment "according to local conditions",which can be applied to the internationalization construction of TCM.It put forward the implementation of recommendations to create a full range of Chinese medicine open pattern.

ObjectiveTo investigate prognostic factors in Stage Ⅲ non-small cell lung cancer (NSCLC)treated with definitive radiation therapy (RT) with PET-CT-based radiotherapy planning. MethodsFifty nine patients with Stage Ⅲ NSCLC treated with radiation therapy of 60 Gy or more were enrolled into this study.The impact of prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The following-up rate was 98％.Nineteen patients completed 2 years' followed-up. The overall l-year and 2-year survival rate was 66％ and 37％, respectively, with a median survival time of 17 months. At a univariate analysis, cigarette smoking status, T stage, radiation dose, the standardized uptake value, the gross tumor volume and clinical stage were significant prognostic factors ( x2 =7.46,7. 52,8.37,4. 97,5.82,4. 37, P =0. 006,0. 006,0. 004,0. 026,0. 016,0. 037, respectively ).At multivariate analyses, cigarette smoking status, radiation dose, gross tumor volume and clinical stage were significant prognostic factors ( x2 =6. 20, 9. 69, 6. 39, 10. 09, P =0. 013,0. 002, 0. 011,0. 001,respectively). Conclusions Cigarette smoking status, radiation dose, gross tumor volume and clinical stage are significant prognostic factors on survival in patients with Stage Ⅲ NSCLC treated with RT based on PET-CT radiotherapy planning.

BACKGROUND: The neurotoxicity and cardiotoxicity of bupivacaine have been reported frequently. However, the studies on bupivacaine-induced muscle toxicity are few.
OBJECTIVE: To establish and evaluate local intramuscular injection of bupivacaine on the changes in histomorphology and ultrastructure of rat multifidus muscle at various time points.
METHODS: A total of 54 male Sprague-Dawley rats weighing 280-320 g were randomly divided into black group (n=18), model group (n=18) and model control group (n=18). Each group was then equal y subdivided into three subgroups according to time points (4, 7 and 14 days) (n=6). Both sides of multifidus muscle of the rats (L4 and L5) were injected with 0.5% bupivacaine. The morphological and ultrastructural changes of multifidus muscle were observed and analyzed with light microscope and transmission electron microscope at 4, 7 and 14 days after model establishment.
RESULTS AND CONCLUSION: (1) A single intramuscular injection of 0.5% bupivacaine induced muscular damage. (2) Hematoxylin-eosin staining results showed fiber necrosis, inflammatory cel infiltration, and a smal amount of macrophages in local skeletal muscle. (3) Under the transmission electron microscope, the structure of myofibrils was destroyed or disintegrated; kinds of bands and lines were indistinct, disrupted or disappeared; the structure of mitochondria was abnormal, the mitochondrial cristae were reduced or disappeared. In the 7- and 14-day groups, multifidus muscle proliferated and repaired. (4) Ultrastructural change scores in skeletal muscle were significantly higher in the model group than in the blank and model control groups (P < 0.05). Above scores were significantly greater in the 4-day group than in the 7- and 14-day groups (P < 0.05), and higher in the 7-day group than in the 14-day group (P < 0.05). (5) Results suggest that a single intramuscular injection of 0.5% bupivacaine can result in pathological changes of skeletal muscle from morphology and ultrastructure. This method can establish a suitable model of skeletal muscle injury.

OBJECTIVETo observe the effect of Xuefu Zhuyu decoction on serum asymmetric dimethylarginine (ADMA) level of the atherosclerosis rabbits.

METHODTwenty-four male rabbits were randomly divided into three groups: control group (n = 8) was fed with normal diet; the model group (n = 8) was fed with high fat/high cholesterol diet; and Xuefu Zhuyu decoction group (n = 8) was fed with high fat/high cholesterol diet and intragastric administrated with Xuefu Zhuyu decoction 7.10 g x kg(-1) x d(-1). Concentrations of serum total cholesterol (TC), total triglyceride (TG), low density lipoprotein (LDL), serum ADMA and serum nitric oxide (NO) were measured after eight weeks. Rabbits' aorta were made into the pathological section to observe the pathology changes degree and atherosclerotic plaqu mean gray value and plaque area were analyzed by OPTIMAS image analysis system.

RESULT1) Compared with the aortic atherosclerotic plaqu mean gray value of Xuefu Zhuyu decoction group 175.56 +/- 12.30, those of the model group 198.91 +/- 5.08 were significant higher (P < 0.01). Significant difference were found between the the aortic atherosclerotic plaque area of the model group (4.80 +/- 0.83) mm2 and Xuefu Zhuyu decoction group (1.96 +/- 0.48) mm2 (P < 0.01). There were no atherosclerotic plaque in the control group rabbits' aorta. 2) The serum TC (23.42 +/- 7.80) mmol x L(-1), TG (2.37 +/- 0.42) mmol x L(-1) and LDL (17.24 +/- 8.29) mmol x L(-1) of the model group were higher than those of Xuefu Zhuyu decoction group (P < 0.01); Compared with control group, the serum TC (15.63 +/- 4.12) mmol x L(-1) and LDL (7.64 +/- 2.36) mmol x L(-1) of the Xuefu Zhuyu decoction group increased significantly, while there were no significant changes between serum TG of control group (1.11 +/- 0.26) mmol x L(-1) and serum TG of Xuefu Zhuyu decoction group (1.43 +/- 0.34) mmol x L(-1). The serum ADMA of the model group (1.57 +/- 0.17) micromol x L(-1) were higher than those of Xuefu Zhuyu decoction group (1.01 +/- 0.13) micromol x L(-1) (P < 0.01), while the serum NO of the model group (8.76 +/- 2.42) micromol x L(-1) were significantly lower than those of Xuefu Zhuyu decoction group (15.90 +/- 2.38) micromol x L(-1) (P < 0.01). There were no significant difference between the serum ADMA of the control group (0.93 +/- 0.11) micromol x L(-1) and Xuefu Zhuyu decoction group. Compared with Xuefu Zhuyu decoction group, the serum NO of the control group (17.88 +/- 3.34) micromol x L(-1) have no significant difference. 3) The serum ADMA of all rabbits negatively correlated to the serum NO (r = -0.773), (P < 0.01).

CONCLUSIONXuefu Zhuyu decoction can decrease the serum ADMA level in atherosclerosis rabbits. The effect of Xuefu Zhuyu decoction on anti-atherosclerosis may be related to the decreased serum ADMA level.

Animals ; Arginine ; analogs & derivatives ; blood ; Atherosclerosis ; blood ; drug therapy ; Cholesterol ; blood ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Rabbits ; Random Allocation ; Triglycerides ; blood

OBJECTIVETo Verify the safety and reliability of one-stage repair of complete cleft Lip and palate in infancy and to obtain the primary result.

METHODSThe simultaneous repair of complete cleft Lip and palate in infants 3 to 12 months of age were performed in 271 cases. The deformities include 185 cases of typical complete unilateral clefts and 75 cases of complete bilateral clefts, and other 11 atypical cleft infants. The preoperative orthopedic treatment for wide alveolar cleft was undertaken in 24 infants and the lip appearance and speech outcome were evaluated in 116 children by 1 to 4 years' postoperative follow-up.

RESULTSAll infants, except for dyspnea in 2 babies, palatal fistula formation in 6 cases and temporary wound hemorrhage in 5 infants, were recovered without complications. After orthopedic treatment, the width of the alveolar cleft was reduced 6.1 mm in average. The evaluation showed that 93.1% of children had got good or excellent lip appearance. And the acceptable or excellent speech was found in 94.8% children.

CONCLUSIONSSimultaneous repair of complete cleft lip and palate in infancy is safety and reliable. The preoperative orthopedic procedure is able to reduce the wide alveolar cleft and to achieve alignment of alveolar segments. The acceptable and or excellent lip appearance and speech function could be obtained in this one-stage operative procedure in infants.

Cleft Lip ; surgery ; Cleft Palate ; surgery ; Female ; Humans ; Infant ; Male ; Treatment Outcome

Objective To investigate the effects of titanium miniplates used for anchorage between the maxilla and the mandible for maxilly hypoplasia in cleft patients.Methods Miniplates were inserted into the infrazygomatic crests and between the canine and lateral incisor in the mandible on both the right and left sides in 6 subjects (mean age,11.3 years).Maxillomandibular elastics were attached between the upper and lower miniplates on each side.Cephalometric radiographs of each patient were evaluated at the beginning of treatment and at the end of active protraction treatment.Results A-point movement was increased mean 3.67 mm,SNA angle and ANB angle were increased by 2.75° and 3.1° respectively.Wit's appraisal was increased by 4.52 mm,and upper lip to E-plane was decreased mean 2.8 mm in a mean of 15 months and the significant difference was found (P＜0.05).Miniplates stability was excellent in all patients throughout treatment.Conclusions Remarkable advancement in the middle face and consequent fullness in the soft-tissue profile can be achieved by using titanium miniplates protraction for maxilly hypoplasia in cleft patients in the late mixed-dentition and initial stage of permanent dentition period.