Objective To study the operation design and surgical methods for terminal surgical reconstruction of severe post-midfacial fracture deformities. Methods From July 1997 to December 2002,11 cases of severe and complex post-midfacial deformities were reconstructed. There were four cases with Le Fort Ⅰ, Ⅱ and Ⅲ fractures,five with Le Fort Ⅰ and Ⅲ fractures and two with Le Fort Ⅰ and Ⅱ fractures combined with right orbital-zygomatic fractures. Typical bicoronal and subcilliary incisions and intra-oral approach were employed to expose all the fractured sites. The displaced orbito-zygomatic bone fragments were repositioned firstly in order to reconstruct the outer midfacial framework. Then, the malunited maxilla was reduced to its proper position after osteotomy of Le Fort Ⅰ fractures under the guidance of mandible through inter-maxilla fixation. The depressed naso-orbital region were reconstructed using autogeneous outer cranial table. Meanwhile, nasal framework reconstruction, medial canthal tendon reapproximation and plasty, and fractured orbital walls repairing were performed to correct the enophathalmos. Results All the cases recovered well and the post-operative facial appearance and occlusal function were improved obviously. Conclusions Complex midfacial fractures, usually involving orbital-zygomatic bone, naso-orbit and maxillary bone, can be well improved through osteotomy and reduction, internal rigid fixation with mini-plates and screws, autogenenous bone grafting and framework reconstruction.

Forty-five patients with burn area exceeding 30% TBSA were studied prospectively. Among these 45 patients, 13 developed multiple organ failure (MSOF). Blood superoxide, dismutase (SOD) activity and plasma malondialdehyde (MDA) levels were sequentially determined to assess the role of excessive release of oxygen radicals and lipid peroxidase injury in the mechanism of pathogenesis of postburn MSOF. The results showed that the anti-oxidation capacity of the body was markedly depressed and lipid peroxidase injury markedly increased after a severe burn injury. These changes were not only related to hypovolemic shock after the injury, but also the severity of the burn injury and infection.

OBJECTIVE To analyze the antimicrobial activity of recombinant human ?-defensin 3(rhBD-3) on clinically isolated multidrug-resistant bacterial strains.METHODS The antimicrobial activity of rhBD-3 on clinically isolated multidrug-resistant Staphylococcus aureus,Enterococcus faecium,Acinetobacter baumannii and Pseudomonas aeruginosa from the wards of burns department was measured by turbidity method.RESULTS rhBD-3 Demonstrated antimicrobial activity against all the strains in a dose-dependent manner.The minimal inhibitory concentration(MIC) to Gram-positive strains and Gram-negative strains was 4 ?g/ml and 8 ?g/ml,respectively.CONCLUSIONS rhBD-3 Has significant antimicrobial activity against clinically isolated multidrug-resistant strains and thus implies therapeutic potential as an effective substitute for the present drug-resistant bacteria.

Objective To investigate the clinical therapeutic effect of Chaishi fever particles on patients with epidemic encephalitis B and to study the machanism of anti-inflammatory.Methods One hundred and twenty one patients with epidemic encephalitis B admitted to the Second Clinical Medical College of Henan University of Chinese Medicine from January 2014 to May 2017 were enrolled, and they were divided into a routine treatment group (60 cases) and a traditional Chinese medicine (TCM) treatment group (61 cases) by random number table. The patients in routine treatment group were given symptomatic support and comprehensive treatment for 15 days, while those in the TCM treatment group were given as that of routine group with the addition of Chaishi fever particles 8 g, 4 times every day, orally taken for consecutive 15 days. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-10) in the serum of two groups were determined by enzyme-linked immunosorbent assay (ELISA), and the clinical therapeutic effect, complications and sequelae in two groups after treatment were observed.Results Compared with the routine treatment group, after treatment the time of body temperature recovering normal (days: 5.8±1.2 vs. 7.5±1.7), the coma time (days: 5.5±1.3 vs. 6.8±1.6), the remission time of convulsion (days: 5.2±1.4 vs. 6.5±1.5), and the length of stay in hospital (days: 22.6±1.9 vs. 25.2±1.8 ) were significantly shorter in TCM treatment group (P < 0.05). After treatment, the levels of serum tumor TNF-α and IL-1β were decreased, IL-10 was increased in both groups, moreover, compared with the routine treatment group, the changes were more obvious in TCM treatment group [TNF-α (μg/L): 11.4±3.6 vs. 14.6±3.5, IL-1β (μg/L): 22.3±6.2 vs. 26.2±5.6, IL-10 (μg/L): 225.2±19.2 vs. 186.2±21.5, allP < 0.05]. In addition, compared with the routine treatment group, the total effective rate was higher [98.3% (60/61) vs. 90.0% (54/60),P < 0.05], and the incidence of sequelae was lower [1.64% (1/61) vs. 13.3% (8/60),P < 0.05] in TCM treatment group.Conclusion The Chaishi fever particles can effectively treat the patients with epidemic encephalitis B and the action is related to the inhibition of inflammatory reaction.

The prognosis of malignant tumors of the digestive system is still a matter of close attention in the medical and health field. At present, evaluating the prognosis of patients with digestive system malignant tumors is mainly based on the TNM staging of the tumor after surgery. As one of the ten characteristics of cancer, inflammatory indicators have certain guiding significance for the prognosis and treatment of patients with malignant tumors of the digestive system. As a new type of inflammation index, the systemic inflammatory response index is significantly better than other traditional inflammatory indexes in evaluating the prognosis of patients with digestive system malignant tumors. This article reviews the related studies on the systemic inflammatory response index in evaluating the prognosis of digestive system malignant tumors.

Objective To investigate expression levels of epithelial mucin 1 (MUC1) and epitbelial mucin15(MUC15) in elderly patients with papillary thyroid carcinoma and assess the role of MUC1 and MUC15 in the pathogenesis of thyroid papillary carcinoma.Methods Protein expression of MUC1 and MUC15 was detected by immunohistochemistry in 10 samples from normal thyroid tissue adjacent to thyroid adenoma,57 samples from papillary thyroid carcinoma (PTC),and 14 samples from PTC in neck lymph node metastasis.Results Expression rates of MUC1 in normal thyroid tissues,thyroid papillary carcinoma,and lymph node metastatic carcinoma were 40.0％,75.4％,64.3,respectively,and the rates for MUC15 were 0,73.7％,71.4％,respectively.The positive expression rate of MUC1 was higher in PTC tissues than in normal thyroid tissues (x2 =5.10,P=0.02) and,compared with normal thyroid tissues,the positive expression rate of MUC15 increased in PTC tissues and lymph node metastatic carcinoma (x2 =12.25 and 19.75,both P＜0.05)MUC15 protein expression was higher in micro-PTC (less than or equal to 1 cm in diameter) than in carcinoma larger than 1 cm in diameter (90.9％ vs.62.9,x2 =5.48,P=0.02).MUC15 expression was higher in PTC without lymph node metastasis than in PTC with lymph node metastasis (83.8％vs.55.0％,x2 =5.55,P=0.02).MUC1 expression was positively correlated with MUC15 expression in thyroid papillary carcinoma (r=0.35,P=0.01).Conclusions MUC1 and MUC15 may have synergistic effects in the initiation and progression of PTC.MUC15 may play a role in regulating tumorigenesis of thyroid papillary carcinoma in early stages and can potentially serve as a supplementary marker in the screening of micro-thyroid papillary carcinoma.

Objective To establish a suitable evaluation index system to track implementation effect of clinical research program.Methods Delphi method was used to creat the evaluation index system.The weighted average method was adopted to determine the weight of each index.Results After two rounds of expert consultation,twenty seven evaluation indices were selected,including three first-class indices,eight second-class indices and sixteen third-class indices,and the weight of each index was determined.Conclusions The evaluation index system reflects the purpose of tracking clinical research to a certain extent.This index system is simple and easy to be used.

Objective To evaluate the feasibility and accuracy of performing dose calculation on megavoltage cone-beam CT(MVCBCT) in the head and neck. Methods MiniCTQC phantom was imaged using MVCBCT scanner, and the MVCBCT value density calibration curve was established. Conventional CT and MVCBCT image of phantom and nasopharyngeal carcinoma(NPC) patient were acquired respectively. Two kinds of single field plan were designed for conventional CT image of phantom,and IMRT plan was used for conventional CT image of a NPC patient. The conventional CT plans were copied to MVCBCT image. The dose distribution was calculated for targets and normal tissues using the MVCBCT value density calibration curve,and compared with that of conventional CT. Results For all the cases,the differences between the calculated dose distributions using MVCBCT and CT were less than 3% and 3 mm in single field plan. In IMRT plan, DVHs of conventional CT and MVCBCT were in excellent agreement. The biggest difference between conventional CT and MVCBCT was 95 cGy with the error of 1.4%. On the isocenter plane,the passing rate was 95.5% ,99.4% ,93.8% ,98.7%, 100% ,94.5% ,97.3% ,95.6% ,99.3% and 99.4% for the beam angle of 0°,45°,90°,120°,160°,200°,240°,280° and 320°. Conclusions Performing dose calculation using MVCBCT in head-and-neck region was feasible, and the dose distributions on the conventional CT and MVCBCT were in excellent agreement.

Objective To quantitatively analyze the image quality of megavoltage cone-beam CT (MVCBCT) under different scanning conditions to provide reference in clinical applications. Methods Si-emens ONCOR linear accelerator with MVCBCT was used to scan the phantom under different conditions. The image quality was evaluated in terms of image noise, uniformity, spatial resolution, contrast resolution, the number of Monitor Units(MUs) used in imaging,and the size of the reconstruction matrix. The comparison of the image quality between MVCBCT and conventional simulator CT was also analyzed. Results The image noise was decreased with the increase of the number of MUs. The uniformity index showed that the system u-niformity was weakly dependent on MU numbers or the size of the reconstruction matrix. Except for the ima-ges with 5 MUs,all other images had the spatial resolution of 0.4 lp/mm with a reconstruction matrix of 256 ×256. Better low contrast resolution was achieved by using more MUs. For typical pelvis and head-and-neck patients,the imaging dose at the center was 0.8 cGy/MU and 0.7 cGy/MU, respectively,and the maxi-mum dose was about 1.2 cGy/MU. For typical abdomen patients,the image maximum dose and center dose was 1.3 cGy/MU and 0.7 cGy/MU,respectively. Conclusions The image quality of MVCBCT is inferior to the conventional kilo-voltage CT. However,with the optimization of the parameters in imaging,we can a-chieve sufficient image contrast in the bone,air and some soft-tissue structures with low imaging dose to pa-tients. Such images can be used for IGRT.

Objective: To compare the efifcacy between emergent and delayed stent implantation in patients with ST-elevation myocardial infarction (STEMI) after thrombus extraction.
Methods: A total of 82 STEMI patients who received thrombus extraction and intracoronary injection of tiroifban, sodium nitroprusside, nitroglycerin via thrombus extraction catheter and with recovered TIMI 3 lfow from 2012-11 to 2014-01 were retrospectively studied. The patients were randomized into 2 groups by SAS software: Emergent group, the patients received stent implantation immediately upon diagnosis and Delayed group, the patients were treated by anti-platelet and anticoagulant medication for 10-14 days, and then received stent implantation. n=41 in each group. The primary and secondary indicators were compared between 2 groups which including ST-segment resolution (STR), the occurrence rate of no-relfow/slow-relfow, myocardial blush grade (MBG) 3, parameters of stent, ventricular remodeling condition, the incidence of major adverse cardiac events (MACE).
Results: ①Delayed group had the post PCI STR at (68.2 ± 9.2)%, TIMI 3 grade at 97.5%, MBG 3 at 69.0%and corrected TIMI frame count (CTFC) at (19.5 ± 5.2), compared with Emergent group, P<0.05. The occurrence rate of no-relfow/slow-relfow in Delayed group and Emergent group were 2.5% and 31.0%, P<0.01. ②The parameters of stents in Delayed group and Emergent group were as the number at (1.21 ± 0.32) vs. (1.76 ± 0.76), the mean length at (28.3 ± 11.7) mm vs. (33.7 ± 12.9) mm, the mean diameter at (3.17 ± 0.76) mm vs. (2.82 ± 0.87) mm, all P<0.01. Delayed group had the higher dilating pressure than that in Emergent group, (18.5 ± 6.2) atm vs (13.6 ± 7.1) atm, P<0.01, and more patients in Delayed group receive high-pressure non-compliant balloon dilation 75% vs 23.8%, P<0.01. ③With 6 months of follow-up study, there were slightly declining trend for LVEF and LVSF in both groups than that at 1 week condition, P>0.05, while LVEDV and LVEDD increased than 1 week, P<0.05, the changes were more obvious in Emergent group, P<0.05. Delayed group had less MACE occurrence, P<0.05.
Conclusion: Delayed stent implantation in STEMI patients after thrombus extraction had reduced incidence of post PCI no-relfow/slow-relfow phenomenon, improved myocardial reperfusion and less MACE occurrence.