Objective To explore the design of a novel acetabulum anatomic locking plate and the clinical application for both column and quadrilateral surface fractures.Methods Clinical and follow-up data of 6 patients with both column fractures involving the quadrilateral plate managed operatively by a novel acetabulum anatomic locking plate from July 2014 to April 2015 were retrospectively analyzed.Among them 4 cases were male and 2 cases were female,with an average age of 35.1 years old (range,24-52 years old).The mean time from injury to operation was 7.2 d (range,2-12 d).According to the fracture classification of Letournel-Judet,there were all associated with two column fractures involving the quadrilateral plate..All patients managed operatively by the novel acetabulum anatomic locking plate,which can simultaneous manage both column and quadrilateral surface fractures through the single superior ilioinguinal approach.The image results by Matta standard were evaluated and the results of acetabular function after surgery were assessed by Merle d'Aubigne-Postel.Results The 6 patients were followed up for at least 14 months (range,12-22 months).Average blood loss was 860 ml,and average operative time was 286 min.The mean time of bony union was 4.3 months.According to the criteria described by Matta,66.7％ of the reductions were graded excellent,16.7％ were graded good,and 16.7％ were poor.Clinical outcomes (Merle d'Aubigne-Postel) at 12 months were 66.7％ excellent,16.7％ good,and 16.7％ poor.One patient (4.5％) had an iatrogenic injury of internal iliac artery during operation.Unilateral iliac artery embolization was performed.One patient had a fatty fluidization.No surgical site infection,femoral head avascular necrosis and traumatic arthritis occurred.Conclusion The novel acetabulum anatomic locking plates for both column and quadrilateral surface can provide strong and stable fixation for complex acetabular fractures through the single superior ilioinguinal approach.It can achieve satisfactory reduction and approving clinical functions.

Objective: To explore the impact of nuclear factor-kappa B (NF-κB) in patients with left-to-right shunt congenital heart disease (CHD) combining pulmonary arterial hypertension (PAH) and its clinical signiifcance. Methods: A total of 78 relevant patients were enrolled in this study. According to mean pulmonary artery pressure (mPAP) measured during operation, the patients were divided into 4 groups: Non-PAH group, the patients with mPAP≤25 mmHg,n=20, Mild PAH group, 25 mmHg mPAP≤35 mmHg,n=21, Moderate PAH group, 35 mmHg45 mmHg,n=23. 2 mL pulmonary artery blood was taken from each patient and plasma level of NF-κB was measured by ELISA to study the relationship between NF-κB and mPAP. Results: Pulmonary arterial plasma levels of NF-κB were increased accordingly as in Non-PAH group was (180.59 ± 10.16) ng/L, in Mild PAH group was (572.83 ± 34.80) ng/L, in Moderate PAH group was (980.85 ± 24.95) ng/L and in Severe PAH group was (1 253.4 ±130.8) ng/L, allP<0.01; NF-κB level was positively related to mPAP (r=0.856,P<0.01). Conclusion: Plasma level of NF-κB was involved in the pathological physiology process of left-to-right shunt CHD combining PAH, it couldbe used as one of the references for distinguishing the severity of PAH and for monitoring the dynamic changes of PAH in relevant patients.

Objective To investigate the diagnostic value of heart-type fatty acid binding protein (H-FABP) versus cardiac trofonin I (cTnI) and creatinekinase-MB (CK-MB) in early diagnosis of acute myocardial infarction (AMI) in elderly patients.Methods 67 patients with acute chest pain were selceted sequentially and divided into AMI group (n＝30) and non-AMI group (n=37).Plasma H-FABP level was rapidly detected by using colloidal gold reagent plate and solid phase immunochromatographic assay for qualitative determination within and after 6 hours of AMI onset.Plasma levels of cTnI and CK-MB were determined within and after 6 hours of onset.The diagnositic value of H-FABP,cTnI and CK-MB in AMI was compared within and after 6 hours of onset.Results The sensitivity of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (93.3％ vs.46.6％,23.3％,both P＜0.05).The negative predictive value of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (94.7％ vs.69.8％,61.1％,both P＜ 0.05) While,positive predictive value and specificity were basically the same between H-FABP,versus cTnI and CK-MB.H-FABP and cTnI levels had significant differences between AMI and non AMI group after 6 hours of onset (all P＜0.05).Plasma levels of cTnl and CK-MB were higher after 6 hours than within6 hours [cTnI (4.10±1.79) mg/L vs.(1.45±1.31) mg/L,CK MB(180.52± 158.70) U/L vs.(20.02± 7.97) U/L,both P＜0.05].Conclusions As compared with cTnI and CK-MB,within 6 hours after AMI onset,H-FABP as a new myocardial necrosis marker has higher sensitivity,specificity,positive and negative predictive values in the diagnosis of AMI.While,after 6 hours of AMI onset,H-FABP has the same diagnostic value as cTnI and CK-MB.

Objective To investigate the effect of autologous platelet rich plasma along with bone transportation in tibia defect.Methods This was a randomized single-blind placebo controlled clinical trial.From Jan 2013 to Mar 2015,28 patients (28 cases) suffering from tibia defect because of trauma or osteomyelitis were randomly assigned to PRP group (PRP along with bone transportation,n=15) or bone transportation group (bone transportation only,n=13) through random number table and sealed envelop method.PRP group:male to female 12∶3,average age:40.9 years old,average bone defect:7.1 cm,6 caused by trauma,9 by osteomyelitis;while bone transportation group:male to female 10∶3,average age:37.7 years old,average bone defect:6.5 cm,3 caused by trauma and 10 by osteomyelitis.Bony results and tibia function were evaluated according to the Association of the Study and Application of the Method of Ilizarov (ASAMI) protocol.The external fixation index,complications and VAS pain score were also evaluated.Results The mean follow-up time was 21.8 m in PRP group and 23.2 m in bone transportation group and there were no loss to follow-up.There were no differences between two groups on postoperative VAS pain score:1st d postoperative (3.33±2.58 vs 4.46±2.73);7th d postoperative (2.67±2.09 vs 3.00±2.20);and 2 weeks postoperative (1.46± 1.77 vs 2.62±2.72).There was significant difference between two groups on external fixation index (37.9±7.7 d/cm vs 46.9± 13.7 d/cm).According to the ASAMI protocol,all patients achieve bone union,except 2 cases in control group which need revision surgery;excellent and good rate of bone defect union was 93％ in PRP group while 77％ in control group;while no difference was found on complication and lower extremity function.Conclusion Application of PRP along with bone transportation in the treatment of tibia defect resuits in shorter healing duration and external fixation duration.But no short-term postoperative analgesic effect,lower extremity function,and complication rates were found.

Objective To investigate the expression pattern of transcription factor Olig 2 in cuprizone-induced mouse model of acute demyelination .Methods C57BL/6 mice were fed with 0.2%cuprizone to induce acute demyelina-tion.Immunofluorescence and qRT-PCR were used, and Olig2, MBP and GFAP were detected in the brain tissues of con-trol group and cuprizone-treated groups for 6 weeks and recovery for 2 weeks.Results Severe demyelination occurred in the corpus callosum following 6-weeks exposure to cuprizone , while remyelination was detected in the white matter after the mice were given diet without cuprizone .In the normal mice , Olig2 was expressed in a low level , while the experessions of Olig2 and GFAP were significantly increased , and Olig2 +/GFAP+cells were detected after demyelination .But the expres-sion of MBP was below the normal level with demyelination .After recovery for 2 weeks, the experession of Olig2 was lower, but the experessions of MBP and GFAP were increased .Conclusions Olig2 may play an important role in the glial differ-entiation from neural progenitor cells into active astrocytes , and in the glial scar formation .

Objective:To investigate the clinical effect of thin superficial inferior epigastric artery flaps in repairing soft tissue defects after buccal cancer surgery.Methods:From January 2018 to October 2019, 6 patients with buccal cancer who underwent surgery were constructed with thin superficial inferior epigastric artery flaps, including 2 males and 4 females, aged 43 to 68 years, with an average of 61.5 years. Doppler ultrasound was utilized of all patients to design flap preoperatively . According to the size of the affected area defect, according to the shape and direction of the blood vessels, a thin superficial inferior epigastric artery flap was elevated above the Scarpas fascia layer and transferred to repair soft tissue defects after buccal cancer surgery. The survival and functional recovery of the flap were observed.Results:All 6 flaps survived. The superficial inferior epigastric artery flaps ranged from 5.0 cm×7.0 cm to 7.0 cm×9.0 cm. The thickness of the flaps ranged from 0.5 cm to 1.3 cm, and the average thickness was 0.8 cm. The pedicle length is 6.0-9.0 cm.Four of them anastomosed to the superficial inferior epigastric veins and companion vein, 2 cases only anastomized superficial inferior epigastric veins . The follow-up period ranged from 3 to 12 months, with an average of 10 months. The cheek shape was good, the mouth opening was normal, there was no obvious bloating, and no secondary surgery was required. Linear scars were left on the donor site, with concealed location and no impairment of abdominal wall function.Conclusions:The donor site of the thin superficial inferior epigastric artery flap is small, the scar is concealed, the cheek is not bloated, and the opening degree of mouth is satisfactory. It is a good choice for reconstructing postoperative defect of cheek cancer.

Objective:The aim of this study was to explore the application of maxillary osteotomy plate and positioning guide plate in maxillary Le Fort Ⅰ osteotomy to eliminate the postoperative error caused by condylar displacement.Methods:Patients suffered from skeletal malocclusion and needed Le Fort Ⅰ osteotomy between January 2018 and November 2020 were selected from the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Bengbu Medical College. All patients were scanned with 64 slice spiral CT. The DICOM format data were analyzed using the Simplant software to reconstruct the virtual three-dimensional model of the jaw before operation. Then, the measurement of indexes and the maxillary Le Fort Ⅰ osteotomy were carried out on the virtual three-dimensional model, respectively. 3D-printed osteotomy guide plate and positioning guide plate were used to determine the osteotomy line and the position of maxillary advancement. 3D-printed tooth supported occlusal plate was used to support the mandibular sagittal split and retraction. The differences of 10 indexes between the two groups (virtual operation and surgery) were analyzed by paired t test using SPSS 22.0. Results:A total of 8 patients (5 males and 3 females) needed maxillary Le Fort Ⅰ osteotomy aged from 18 to 39 years old were recorded. The deviation of age in these patients was 24.8. The 3D-printed guide plate and tooth supporting occlusal plate were positioned accurately in surgery. All the operations were successful with primary healing of the incision and stable occlusion, and without joint clicking. There was no significant difference on the 10 indexes between the groups of virtual operation and surgery ( P>0.05). Conclusions:The application of maxillary osteotomy plate and positioning guide plate can effectively and accurately control the three-dimensional movement of the maxilla and improve the precision of maxillary Le fort Ⅰ osteotomy in orthognathic surgery, making the surgical effect highly consistent with the preoperative design.

Objective:To investigate the clinical effect of thin superficial inferior epigastric artery flaps in repairing soft tissue defects after buccal cancer surgery.Methods:From January 2018 to October 2019, 6 patients with buccal cancer who underwent surgery were constructed with thin superficial inferior epigastric artery flaps, including 2 males and 4 females, aged 43 to 68 years, with an average of 61.5 years. Doppler ultrasound was utilized of all patients to design flap preoperatively . According to the size of the affected area defect, according to the shape and direction of the blood vessels, a thin superficial inferior epigastric artery flap was elevated above the Scarpas fascia layer and transferred to repair soft tissue defects after buccal cancer surgery. The survival and functional recovery of the flap were observed.Results:All 6 flaps survived. The superficial inferior epigastric artery flaps ranged from 5.0 cm×7.0 cm to 7.0 cm×9.0 cm. The thickness of the flaps ranged from 0.5 cm to 1.3 cm, and the average thickness was 0.8 cm. The pedicle length is 6.0-9.0 cm.Four of them anastomosed to the superficial inferior epigastric veins and companion vein, 2 cases only anastomized superficial inferior epigastric veins . The follow-up period ranged from 3 to 12 months, with an average of 10 months. The cheek shape was good, the mouth opening was normal, there was no obvious bloating, and no secondary surgery was required. Linear scars were left on the donor site, with concealed location and no impairment of abdominal wall function.Conclusions:The donor site of the thin superficial inferior epigastric artery flap is small, the scar is concealed, the cheek is not bloated, and the opening degree of mouth is satisfactory. It is a good choice for reconstructing postoperative defect of cheek cancer.

Objective:The aim of this study was to explore the application of maxillary osteotomy plate and positioning guide plate in maxillary Le Fort Ⅰ osteotomy to eliminate the postoperative error caused by condylar displacement.Methods:Patients suffered from skeletal malocclusion and needed Le Fort Ⅰ osteotomy between January 2018 and November 2020 were selected from the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Bengbu Medical College. All patients were scanned with 64 slice spiral CT. The DICOM format data were analyzed using the Simplant software to reconstruct the virtual three-dimensional model of the jaw before operation. Then, the measurement of indexes and the maxillary Le Fort Ⅰ osteotomy were carried out on the virtual three-dimensional model, respectively. 3D-printed osteotomy guide plate and positioning guide plate were used to determine the osteotomy line and the position of maxillary advancement. 3D-printed tooth supported occlusal plate was used to support the mandibular sagittal split and retraction. The differences of 10 indexes between the two groups (virtual operation and surgery) were analyzed by paired t test using SPSS 22.0. Results:A total of 8 patients (5 males and 3 females) needed maxillary Le Fort Ⅰ osteotomy aged from 18 to 39 years old were recorded. The deviation of age in these patients was 24.8. The 3D-printed guide plate and tooth supporting occlusal plate were positioned accurately in surgery. All the operations were successful with primary healing of the incision and stable occlusion, and without joint clicking. There was no significant difference on the 10 indexes between the groups of virtual operation and surgery ( P>0.05). Conclusions:The application of maxillary osteotomy plate and positioning guide plate can effectively and accurately control the three-dimensional movement of the maxilla and improve the precision of maxillary Le fort Ⅰ osteotomy in orthognathic surgery, making the surgical effect highly consistent with the preoperative design.

Objective To investigate the clinical efficacy of a novel acetabulum anatomic locking plate in the treatment of anterior wall and anterior column acetabular fracture.Methods A retrospective case series study was performed in five patients with anterior wall and anterior column acetabular fractures managed operatively using a novel acetabulum anatomic locking plate from March 2014 to January 2016.There were four males and one female,with an average age of 41.1 years (range,25-65 years).The mean time from injury to operation was 3.2 days (range,2-5 days).All patients were managed operatively using the superior ilioinguinal approach.Operation duration,intraoperative blood loss,blood transfusion,and bony union time were recorded.The image results by Matta standard were evaluated and the acetabular function after operation was assessed by modified Merle d'Aubigné-Postel.Postoperative complications were recorded.Results All patients were followed up for average 15.3 months (range,12-24 months).The average operation duration was 96 minutes (range,60-130 minutes) and average blood loss was 230 ml (range,100-800 ml).Autologous blood transfusion was selectively used except for one patient with allogeneic blood transfusion of 400 ml.The mean time of bony union was 2.9 months (range,2-5 months).According to the Matta criteria,four patients attained anatomical reduction,and unsatisfactory reduction was reported in one patient.Clinical outcomes (Merled'Aubigné-Postel) at 12 months were 100％ excellent with the average score of 17.1 (range,15-18).One patient had a lateral cutaneous nerve palsy,and symptom relief was seen after a follow up of 6 months.After operation,no complications such as surgical site infection,femoral head avascular necrosis,andtraumatic arthritis occurred in any patient.Conclusion The novel acetabulum anatomic locking platecan provide rigid and firm fixation for both anterior wall and anterior acetabular fractures using one singleplate,and the fracture reduction and function recovery are satisfactory.