BACKGROUND:Prefabricated customized bone flaps have the advantages of few trauma, good vascularization, ossification with predetermined shape, and can be used to restore bone defects with compromised blood bed.
OBJECTIVE:To establish animal models of mandibular reconstruction with prefabricated, customized bone flaps.
METHODS:After computed tomography scanning of nine rhesus’ head, customized meshes were made. After loading with recombinant human bone morphogenetic protein-2-incorporated demineralized freeze-dried bone al ograft (DFDBA) or coral ine hydroxyapatite (CHA), the constructs were implanted in latissimus dorsi muscle. Meanwhile, segmental mandibular defects were created, and the customized meshes loaded with DFDBA, CHA, or recombinant human bone morphogenetic protein-2-incooperated DFDBA and CHA were implanted in situ. At 13 weeks, prefabricated bone flaps with recombinant human bone morphogenetic protein-2-incorporated DFDBA or CHA were transferred to repair segmental mandibular defects. Clinical and histological analyses were used to evaluate the ossification and vascularization of the prefabricated implants in ectopic and orthotopic sites.
RESULTS AND CONCLUSION:Segmental mandibular defects were successful y restored with prefabricated bone flaps and recombinant human bone morphogenetic protein-2-incorporated CHA in situ, but other segmental mandibular defects remained with recombinant human bone morphogenetic protein-2-incorporated DFDBA, DFDBA and CHA in situ. Moreover, mandibles reconstructed with prefabricated bone flaps revealed more regenerated and homogeneous bone formation than other reconstructions. These findings suggest that the animal model of mandibular reconstruction with prefabricated, customized bone in rhesus monkey is applicable.

Objective To analyze our clinical results of head and neck reconstruction using microsur- gical free flap transfer techniques.Methods The free flap donor sites with long vascular pedicle and large diameter of vessel were routinely chosed,and chose receipt vessels with large diameter and proper position, and perform vessel ananstomosis under surgical loups instead of microscope.The un-buried free flap with a mo- nitoring window were harvest,and do double venous anastomoses in some flaps to ensure adequate venous out- flow.Results From May 1999 to March 2005,1066 consecutive free flap transfers were used to reconstruct head and neck defects.The overall success rate of free flap was 98.3%.The vessel thrombosis rate was 3.1%,and the flap salvage rate was 45.5%.Conclusion Head and neck reconstruetion using microsurgi- cal free flap transfer technique is safe and reliable,and good clinical results can be obtained.

OBJECTIVETo explore the correlation among prevertebral hyperintensity (PVH), sagittal canal diameter on MRI and neurologic function of patients after cervical vertebral hyperextension injury without fracture and dislocation.

METHODSThe clinical data of 100 patients with cervical vertebral hyperextension injury without fracture and dislocation were retrospectively analyzed from September 2010 to December 2013. The patients were divided into PVH group and non-PVH group according to the presence of PVH on T2-weighted magnetic resonance imaging. There were 39 patients in PVH group, including 31 males and 8 females, aged from 21 to 83 years old with an average of (58.10 ± 14.78) years; and the other 69 patients in non-PVH group, including 49 males and 12 females, aged from 32 to 77 years old with an average of (55.05 ± 10.36) years. The sagittal disc level canal diameters of subaxial cervical spine were measured on mid-sagittal magnetic resonance imaging. The age, sex, cause of injury, and the segments of spinal stenosis were recorded. American Spinal Injury Association (ASIA) impairment scale and motor score were used to evaluate the neurological status.

RESULTSThe ASIA motor score of the group with PVH was 52.56 ± 31.97 while the ASIA motor score was 67.70 ± 22.83 in non-PVH group (P = 0.013). More patients with intramedullary hyperintensity signal on MRI were observed in the PVH group than in non-PVH group (P = 0.006). There was a significant positive correlation between ASIA motor score and sagittal disc level canal diameter of injury segment (P = 0.003). The neurological status was worse in patients with multi-level sagittal canal diameters below 8 mm.

CONCLUSIONThe PVH and the disc-level canal sagittal diameter of the injury segment are associated with neurological status. The patients with multi-level sagittal canal stenosis are vulnerable to severe cervical spinal cord injury.

Adult ; Aged ; Aged, 80 and over ; Cervical Vertebrae ; injuries ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Spinal Canal ; pathology ; Spinal Cord Injuries ; pathology ; physiopathology

PURPOSE: To compare the aqueous concentrations of cytokines in glaucomatous eyes with those of normal controls and to characterize the clinical factors associated with aqueous cytokine concentration. METHODS: In this cross-sectional study, aqueous humor samples were collected from 54 eyes of 54 patients (34 medically treated primary open angle glaucoma and 20 normal controls) during cataract surgery from January 2014 to January 2015. Glaucoma patients were divided into two groups: patients using prostaglandin analogue for more than 6 months (prostaglandin F2α analogue [PGA] user) and patients with no experience of PGA use (PGA non-user). The levels of cytokines (matrix metalloproteinase [MMP]1, MMP9, MMP3, vascular endothelial growth factor, interleukin [IL]-1, IL-8, tumor necrosis factor [TNF]-α) in the aqueous of glaucoma and control subjects were quantified using a multiplex cytokine analysis. RESULTS: Aqueous humor collected from the glaucoma patients exhibited significantly increased concentrations of MMP1 (p = 0.002) and MMP9 (p = 0.026). Among glaucoma patients, PGA users showed significantly higher level of MMP 9 compared with PGA non-users (p = 0.003). In the univariate and multivariate linear regression analyses, PGA use (β = 0.351, p = 0.027) and vertical cup-to disc ratio (β = -0.401, p = 0.013) were the significant risk factors associated with the level of MMP9. CONCLUSIONS: Primary open-angle glaucoma showed increased aqueous levels of MMP1 and MMP9. Especially, PGA use for longer than 6 months was associated with increased level of MMP9.
Aqueous Humor* ; Cataract ; Cross-Sectional Studies ; Cytokines ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Interleukin-8 ; Interleukins ; Linear Models ; Risk Factors ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

PURPOSE: To compare the aqueous concentrations of cytokines in glaucomatous eyes with those of normal controls and to characterize the clinical factors associated with aqueous cytokine concentration. METHODS: In this cross-sectional study, aqueous humor samples were collected from 54 eyes of 54 patients (34 medically treated primary open angle glaucoma and 20 normal controls) during cataract surgery from January 2014 to January 2015. Glaucoma patients were divided into two groups: patients using prostaglandin analogue for more than 6 months (prostaglandin F2α analogue [PGA] user) and patients with no experience of PGA use (PGA non-user). The levels of cytokines (matrix metalloproteinase [MMP]1, MMP9, MMP3, vascular endothelial growth factor, interleukin [IL]-1, IL-8, tumor necrosis factor [TNF]-α) in the aqueous of glaucoma and control subjects were quantified using a multiplex cytokine analysis. RESULTS: Aqueous humor collected from the glaucoma patients exhibited significantly increased concentrations of MMP1 (p = 0.002) and MMP9 (p = 0.026). Among glaucoma patients, PGA users showed significantly higher level of MMP 9 compared with PGA non-users (p = 0.003). In the univariate and multivariate linear regression analyses, PGA use (β = 0.351, p = 0.027) and vertical cup-to disc ratio (β = -0.401, p = 0.013) were the significant risk factors associated with the level of MMP9. CONCLUSIONS: Primary open-angle glaucoma showed increased aqueous levels of MMP1 and MMP9. Especially, PGA use for longer than 6 months was associated with increased level of MMP9.
Aqueous Humor* ; Cataract ; Cross-Sectional Studies ; Cytokines ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Interleukin-8 ; Interleukins ; Linear Models ; Risk Factors ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

PURPOSE: To evaluate the effect of orbital wall reconstruction with absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide by assessment of the orbital volume via orbital computed tomography. METHODS: 24 patients who followed up at least 6 months after orbital wall reconstruction with unsintered hydroxyapatite/poly L-lactide were included. Retrospective clinical chart reviews for clinical manifestations and complications were performed, and orbital volume measurements were taken using the Eclipse Treatment Planning System (ver.13.0, Varian Medical System Inc., Palo Alto, CA, USA) through orbital computed tomography, which were taken before operation, right after operation, and at last follow up. RESULTS: Fourteen patients (58.3%) showed diplopia and extraocular muscle movement limitation preoperatively. Diplopia was resolved at last follow up and extraocular muscle movement limitation was improved at postoperative 6 months for all cases. The mean volumes of the fractured orbit and the unaffected orbit before operation were 23.62 ± 0.45 cm3 and 21.95 ± 1.01 cm3, respectively (p = 0.003). The mean volumes of the fractured orbit and the unaffected orbit right after operation were 21.65 ± 0.91 cm3 and 21.78 ± 0.83 cm3, respectively (p = 0.542). The mean volumes of the fractured orbit and the unaffected orbit at last follow up were 21.84 ± 0.93 cm3 and 21.81 ± 0.91 cm3, respectively (p = 0.889). CONCLUSIONS: Absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide was effective for clinical improvement and orbital volume assessment in cases of orbital wall reconstruction and it can be used safely without definite implant related complications.
Absorbable Implants ; Diplopia ; Follow-Up Studies ; Humans ; Orbit* ; Retrospective Studies

PURPOSE: To evaluate the effect of orbital wall reconstruction with absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide by assessment of the orbital volume via orbital computed tomography. METHODS: 24 patients who followed up at least 6 months after orbital wall reconstruction with unsintered hydroxyapatite/poly L-lactide were included. Retrospective clinical chart reviews for clinical manifestations and complications were performed, and orbital volume measurements were taken using the Eclipse Treatment Planning System (ver.13.0, Varian Medical System Inc., Palo Alto, CA, USA) through orbital computed tomography, which were taken before operation, right after operation, and at last follow up. RESULTS: Fourteen patients (58.3%) showed diplopia and extraocular muscle movement limitation preoperatively. Diplopia was resolved at last follow up and extraocular muscle movement limitation was improved at postoperative 6 months for all cases. The mean volumes of the fractured orbit and the unaffected orbit before operation were 23.62 ± 0.45 cm3 and 21.95 ± 1.01 cm3, respectively (p = 0.003). The mean volumes of the fractured orbit and the unaffected orbit right after operation were 21.65 ± 0.91 cm3 and 21.78 ± 0.83 cm3, respectively (p = 0.542). The mean volumes of the fractured orbit and the unaffected orbit at last follow up were 21.84 ± 0.93 cm3 and 21.81 ± 0.91 cm3, respectively (p = 0.889). CONCLUSIONS: Absorbable osteoconductive unsintered hydroxyapatite/poly L-lactide was effective for clinical improvement and orbital volume assessment in cases of orbital wall reconstruction and it can be used safely without definite implant related complications.
Absorbable Implants ; Diplopia ; Follow-Up Studies ; Humans ; Orbit* ; Retrospective Studies

OBJECTIVETo study the effect of lycopene on red blood cell and the level of blood lipid.

METHODSAccording to the level of serum total cholesterol and weight, forty-eight adult male SD rats were divided randomly into six groups: normal control (group A), fed by normal feed; hyperlipidemia group (group B): fed by high fat diet; positive control group (group C): fed by high fat diet plus 10 mg * kg(-1) * d(-1) fluvastatin sodium; lycopene groups: fed by high fat diet plus 11 (group D), 22 (group E), 44 mg * kg(-1) * d(-1) (group F) lycopene through gavage, respectively. For all six groups, the level of serum total cholesterol (TC) and total triglyceride (TG) were measured at the end of 0, 1, 3 weeks of the study by taking samples from tail vein. At the end of the experiment, RBC and HGB were measured.

RESULTSAfter the rats were fed with high-fat feed for a week, models of hyperlipidemia rats were established. At the end of 3 weeks, TC of group A, B, C, D, E and F were (1.31 +/- 0.05), (19.40 +/- 0.54), (4.66 +/- 0.07), (7.18 +/- 0.06), (5.30 +/- 0.28), (4.49 +/- 0.23) mmol/L (F = 4395.72, P = 0.00), respectively;and TG were (0.42 +/- 0.01), (2.29 +/- 0.42), (0.69 +/- 0.03), (1.10 +/- 0.05), (0.63 +/- 0.02), (0.62 +/- 0.04) mmol/L (F = 127.26, P = 0.00), respectively; HGB were (143.13 +/- 6.33), (112.63 +/- 2.56), (124.75 +/- 3.62), (124.63 +/- 7.78), (132.38 +/- 6.41), (142.13 +/- 5.54) g/L (F = 34.14, P = 0.00), respectively; RBC were (6.75 +/- 0.60) x 10(12)/L, (5.08 +/- 0.75) x 10(12)/L, (7.14 +/- 0.82) x 10(12)/L, (5.94 +/- 1.09) x 10(12)/L, (6.18 +/- 0.36) x 10(12)/L and (7.31 +/- 0.58) x 10(12)/L (F = 10.35, P = 0.00), respectively.

CONCLUSIONLycopene have some protective effects on red blood cells of the hyperlipidemic rats by regulating the blood lipid and antioxidant.

Animals ; Carotenoids ; pharmacology ; Cholesterol ; blood ; Cholesterol, LDL ; blood ; Erythrocytes ; drug effects ; Hypercholesterolemia ; blood ; Lipids ; blood ; Male ; Rats ; Rats, Sprague-Dawley ; Triglycerides ; blood

OBJECTIVEThis is a preliminary study of the endoscopic technique on open surgery. The purpose of this study is to introduce the use of endoscopic technique for the reconstruction of the condyle with costochondral graft through a preauricular incision.

METHODS33 patients of temporomandibular joint diseases (n=49) underwent reconstruction of mandibular condyle with costochondral graft. After preparation of the recipient site through a preauricular incision, maxillo-mandibular fixation, and preparation of the costochondral graft, the graft was fixed to the lateral side of the mandible ramus under the supervision of arthroscope.

RESULTSAll the patients had successful reconstruction of the condyle with costochondral graft without any severe bleeding or craniocerebral injury.

CONCLUSIONThis case series demonstrates the feasibility of endoscopic technique for the reconstruction of the condyle through a preauricular incision. It has the advantage of high efficiency, minimal postoperative morbidity, great patient comfort, and little appearance impairment. The endoscopic technique has a promising future.

Adult ; Arthroscopes ; Endoscopy ; Female ; Humans ; Male ; Mandible ; Mandibular Condyle ; Reconstructive Surgical Procedures ; Temporomandibular Joint Disorders

OBJECTIVETo discuss the diagnosis and treatment of condylar resorption of unknown reason.

METHODSThe clinical data including the records of history, physical examination, radiography and laboratory of ten patients were studied. Ten patients consisted of 8 females and 2 males (mean age 24.1 years, range 19-31 years) had common clinical features including anterior open bite, posterior occlusal prematurities and Class II malocclusion. Images demonstrated a small and short condyle with abnormal shape, usually accompanied by the developmental insufficiency of the ramus and condyle. The condylar, even the ramus, showed the black marrow signal on MRI images. Four patients were treated by condylar reconstruction with costochondral graft after condylectomy under the supervision of endoscope. Two patients were treated by reduction and repair of disk. Four patients didn't accept any treatment.

RESULTSFour patients treated by condylar reconstruction with costochondral graft showed structures with the size and shape morphologically similar to normal joint and achieved a stable occlusion after follow-up of 6-18 months. Two patients treated by reduction and repair of disk didn't show significant change of open bite and remodeling of condyle after follow-up of 4-6 months.

CONCLUSIONThe diagnosis of condylar resorption of unknown reason can be achieved based on the physical examination and radiographical images. The condylar reconstruction with costochondral graft after condylectomy is feasible.

Adolescent ; Adult ; Dental Occlusion ; Female ; Humans ; Male ; Mandibular Condyle ; Retrospective Studies ; Treatment Outcome