Objective: To summarize the experience of repairing or al and maxillofacial defects with radial forearm free flap. Methods: The clinical records of 110 cases received oral and maxillofacial reconstruction with radial forearm free flap were analyzed.Results: Forearm free flap healed well in 10 5 out of the 110 cases.with the overall success rate of 96.4%.Failure was in 4 c ases of cancer.One patient died from cerebral infarction 19 days after operation .Post operation infection did not result in the necrosis of the flaps because o f corresponding treatment in 5 cases.Conclusion: The radia l forearm free flap characterized by the anatomical consistency,easy fold, ideal thickness, flexibility and long pedicle, is feasible in the reconstruction of soft tissue defects in oral and maxillofacial region.

Objective:To discuss the approach of treating the patients who suffered from cystic lesions of the pancreas. Methods:According to the retrospective analysis of all the 127 patients who were diagnosed as cystic lesions of the pancreas by the following methods such as ultrasonography ,CT,MRCP,PET,ERCP,EUS and FNA. Results:48 case of cystic lesions of the pancreas (38%) were selected an initial operation,and 79 of them (62%) selected follow-up visit. Nearly 40% of the patients who chose an initial operation were confirmed to suffer a malignant tumor by pathology. 9 patients(11%) of all the patients in the follow-up accept an operation because of their cystic lesions had a variation. According to the result of the pathology after the resection,3 patients of them had a canceration. The patients in the follow-up whose lesion diameter was smaller than 3cm,not existing a solid lesions,and without signs or symptoms,didn't have a risk in the transition to the malignant mutation. The transition rate was less than 4%,which was similar to the death risk of the patients undergoing resection. Conclusion:It is significant to adopt a careful radioactive follow-up to the surrounding parenchyma of all the patients who had not an initial resection.

Objective:To study the role of tetrodotoxin-resistant(TTX-R)human sodium channel of hNa v1.8 mRNA in trigeminal neuralgia (TN). Methods:The samples of affected trigeminal division(inferior alveolar nerve) and non-affected division(lingual nerve) were surgically obtained from six idiopathic TN patients to whom the drug therapy was not effective.The expression of hNa v1.8 mRNA was assessed by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) with ?-actin as an internal control. A sample of great auricular nerve (from a patient who had to accept the combined radical neck dissection with glossectomy and hemimandibulectomy) and a sample of infraorbital nerve (from a patient who had to accept subtotal resection of maxilla) were used as the negative controls. Resoults:The relative amount of hNa v1.8 mRNA in the affected trigeminal divisions(1.233?0.324) was higher than that in the non-affected divisions(1.018?0.249), t=3.919,P=0.011. Conclusion:The higher expression of hNa v1.8 mRNA in the affected nerves of TN patients may play an important role in TN.

To disscus the characteristics of leukorrhea treatment of the four great famous doctors in Jin-Yuan Danasty, including the recognition of etiopathogenisis and pathogenesis, the view of determination of treatment based on differentiation of symptoms and signs, therapeutical principle and medication. LIU Wan-su believed fireheat was the important factor leading to illness. He firstly advocated differentiating symptoms and signs of leukorrhea with heat and treating it by clearing away heat evil and eliminating damp. ZHANG Zi-he considered the leukorrhea due to humid-heat flowing down to small intestine. He advocated lowing heart fire and tonifying kidney yin as the therapeutical method of leukorrhea with emetic and purgation method. LI Dong-yuan considered the injury of qi of the spleen and stomach was the main factor, so he diagnosed and treated leukorrhea on basis of the spleen and stomach. ZHU Dan-xi deemed leukorrhea happened when damp and sputum obstructed the spleen, so he thought that deprived the evil wetness was the fi rst and important method of treating leukorrhea.

砄bjective: To observe whether substance P(SP), calcitonin gene related peptide(CGRP), vasoactive intestinal polypeptide(VIP),? endorphin(? EP) are related to the pathogenesis of trigeminal neuralgia. Methods: During the attacks of trigeminal neuralgia, SP,CGRP,VIP,? EP in plasma from both external jugular and cubital fossa vein blood ipsilateral to the pain were assessed by sensitive radioimmunoassay in 16 ptients and 10 health controls, after operations the venous blood from the external jugular vein of the patients was sampled again; the external jugular vein blood of normal volunteers was collected as control. SP like and CGRP like immunoreactive positive granules of pain and painless branches were labelled using ABC immunohistochemistry methods; quantitative analysis was performed using HPIAS 1000 system. Results: During the attacks of trigeminal neuralgia, the levels of SP,CGRP,VIP in the external jugular vein blood were significantly higher than those in the cubital fossa vein blood, postoperative external jugular vein blood and the external jugular vein blood of normal volunteers. The plasma levels of ? EP in patients with trigeminal neuralgia were significantly lower than that in normal volunteers.The number and area of SP like ,CGRP like immunoreactive positive granules in the pain branches was much more and larger than those in the painless branches . Conclusion: Abnormal synthesis and release of neuropeptides in patients may be related to the pathogenesis of trigeminal neuralgia.

Objective: To study the effects of capsaicin applied locally to infraorbital nerve on primary afferent nerve inadult rats. Methods:Capsaicin solution (2% ) was directly applied onto one lateral intraorbital nerve, and the contralateralnerve was used as self-control. Both experimental and control infraorbita1 nerves were observed under electron tnicroscope on3, 7, 14, 21, 28, 35 or 42 d after local administration. Substance P(SP)--like immunoreactive positive granules in both lateralnucleus caudalis spinalis nervi trigemini (CNV) were examined by immunohistochemical method. Results: Degenerated un-myelinated fibers in capsaicin-treated nerves were found under electron microscope, and no myelinated fibers changes werefound. The gray scale value of SP-like immunoreactive positive granules in the experimental side was markedly lower thanthat in the control side (P＜0. 01), while no significant difference was observed between different time groups. Conclusion:Local administration of capsaicin can produce selective destruction of unmyelinated fibers in primary afferent nerves, and canreduce the levels of SP in regions of CNV. The results suggest that local administration of capsaicin has potential therapeuticvalue for trigeminal neuralgia.

Objective:To observe whether there is abnormal expression of tetrodotoxin-resistant (TTX-R)hNa v1.8 channel protein in demyelinated fibers of the affected nerves in patients with trigeminal neuralgia(TN), and to explore the relationship between ectopic discharges and TN.Methods: Six affected inferior alveolar nerves obtained from patients with idiopathic TN were studied. One great auricular nerve and one normal inferior alveolar nerve were used,which were obtained from patients undergoing combined radical neck dissection with glossectomy (negative control) and mandibulectomy (normal controls) . One rat spinal nerve was used as positive control. Immunohistochemical method and electron microscope were used to observe the expression of TTX-R hNa v1.8 channel protein in all groups. Results: Strong expression of hNa v1.8 channel protein was found in the demyelinated fibers of the affected nerves in patients with TN, weak expression in the neuraxon of rat spinal nerve,and none in the normal inferior alveolar nerve and the great auricular nerve. Conclusion: Abnormal expression of hNa v1.8 channel protein in the demyelinated fibers in patients with TN may play an important role in the pathogenesis of TN.

Objective To investigate the mechanism of interlekin-6 (IL-6) in wound healing of human biliary epithelial cells ( BECs ).Methods BECs were cultured in IL-6 at different concentrations:0 ng/L(0 ng/L group),10 ng/L (10 ng/L group),50 ng/L (50 ng/L group),100 ng/L (100 ng/L group),1000 ng/L ( 1000 ng/L group).The effects of IL-6 on the phosphorylation of signal transducer and activator of transcription 3( STAT3 ) and the expression of trefoil family factors 3 (TFF3) were detected.BECs were divided into untreated group,STAT3-RNAi group (BECs transfected with STAT3 RNAi adenovirus) and Control-RNAi group (BECs transfected with vacant RNAi adenovirus).The effects of IL-6 on the expression of TFF3 were detected after RNAi of STAT3.In vitro wound models were constructed for the untreated group,STAT3-RNAi group and Control-RNAi group,and the effects of IL-6 and TFF3 on BECs of the 3 groups were detected.All data were analyzed by using the Student's t test,analysis of variance or Sidak test.Results The expressions of phosphorylated STAT3 in the 50 ng/L group,100 ng/L group and 1000 ng/L group were 0.240 ± 0.052,0.714 ± 0.124,0.327 ± 0.069,respectively,which were significantly higher than 0.033 ± 0.011 of the 0 ng/L group (q =5.246,17.260,7.451,P ＜ 0.05 ).The contents of mRNA and protein of TFF3 increased as the increase of IL-6 concentration (q =12.045,9.889,P ＜ 0.05).After RNAi of STAT3 of the BECs,the expression of TFF3 decreased when the concentration of IL-6 was 1000 ng/L.The expression of TFF3 of the STAT3-RNAi group was 0.037 ± 0.005,which was significantly lower than 0.267 ± 0.038 of the Control-RNAi group and 0.301 ± 0.042 in the untreated group ( q =12.135,13.929,P ＜ 0.05 ).In the in vitro wound model,the speed of BECs migration in the STAT3-RNAi group was (9.1 ± 1.5 ) μm/h,which was slower than (25.1 ± 3.8 ) μm/h of the Control-RNAi group after 12 hours of interference with IL-6 (q =7.737,P ＜ 0.05 ).The speed of BECs migration of STAT3-RNAi group was (39.2 ± 4.7) μm/h after adding 1 g/L of recombinant TFF,which was significantly faster than that of the Control-RNAi group (q =14.507,P ＜0.05).Conclusion IL-6 promotes cell migration and wound healing by activating STAT3 and up-regulating TFF3 expression.

Objective To evaluate the clinical feature of malignant ameloblastoma. Methods A review of 25 cases of malignant ameloblastoma was presented with respect to age, sex, primary site and times of recurrence, site and time of metastasis, results of follow up, pathological type. Results Male patients outnumbered female patients by 1.5 to1. The median age at which the primary tumor was first treated was 30.5 years. The primary sites were mandible(17), maxilla(5), tibia(1), rib(1), ulna(1). The most metastases were found in lung(80%), with cervical lymph nodes and liver each representing 24% and 12% of the metastatic sites. Other sites of metastasis included brain(1), femur(1), thoracic spine(1), spleen(1), myocardial(1), mediastinum(1). The median times of primary recurrence was 2.5 times. The median survival time after metastasis was 2 years. There were four pathological types which were follicular type(4), plexiform type(2), acanthomatous type(1), granular type(1). Conclusins Multiple recurrences developed in most of the 25 patients. The time between diagnosis of primary tumor and appearance of metastasis in 25 patients was long. The most frequent sites of metastasis was lung and cervical lymph nodes. Early adequate resection of the primary tumor to avoid repeated surgical intervention is advocated to prevent tumor spread.

OBJECTIVEThe aim of this study was to observe whether vasoactive intestinal polypeptide (VIP) participated in the attack of trigeminal neuralgia, and to understand further its pathogenetic mechanism.

METHODSSixteen patients were studied. During the attacks the venous blood was sampled from both the external jugular vein and cubital fossa vein ipsilateral to the pain, and after operations the venous blood from the external jugular vein was sampled again, the external jugular vein blood of eleven normal volunteers was collected as the control. Plasma levels of VIP were determined using sensitive radioimmunoassays.

RESULTSDuring the attacks of trigeminal neuralgia the levels of VIP in the external jugular vein blood were significantly higher than that in the cubital fossa vein blood, postoperative external jugular vein blood and the external jugular vein blood of normal volunteers.

CONCLUSIONVIP indeed participates in the attack of trigeminal neuralgia in the local region, the role of VIP may be relating to enhancing the effects of substance P in local neurogenic inflammation.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Radioimmunoassay ; Substance P ; metabolism ; Trigeminal Neuralgia ; blood ; Vasoactive Intestinal Peptide ; blood