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.

Objective To investigate the value of multi-slice spiral CT in the diagnosis of small lung adenocarcinomas. Methods Fourteen patients underwent thin multi-slice spiral CT scan. Images were post-processed and 2 kinds of postprocessing images including multiple planar reconstruction (MPR) and minimum intensity projection (MinIP) were performed. The image characteristics of the tumors assessed by multi-slice spiral CT were correlated with the clinical/pathological manifestation. Results In 14 cases of small lung adenocarcinoma, tumor density had two forms. Four of five cases with localized bronchioloalveolar carcinoma (LBAC) showed total or partial ground-glass opacity, and 9 adenocarcinomas showed solid attenuation. 3 cases with LBAC showed partial ground-glass opacity mixed with airway dilatation. MPR in 14 patients clearly showed interlobar pleura and image characteristics of the tumors. MinIP in 10 cases were able to demonstrate 5～6 scale bronchial divisions and presented air bronchogram of tumors in a vivid way. Conclusion Thin multi-slice spiral CT scan and reconstruction images can play an important role and are the valuable method in the diagnosis of small lung adenocarcinomas.

BACKGROUND:The bony crista has been found in the distal humeral medullary cavity,but its specific morphological characteristics and clinical significance are not clear.OBJECTIVE:To study the morphology of bony crista inside the distal intramedullary of the human humerus and its potential clinical relevance.DESIGN,TIME AND SETTING:CT scanning and measurement as well as visualized observation to the specimen for the dry adult humeri was performed at CT Room and Department of Orthopaedics,First Affiliated Hospital,Nanchang University from June to December 2007.MATERIALS:A total of 80 dry adult humeri (left:49;right:31) were purchased from the Department of Anatomy,Medical College of Nanchang University,excluding the fractured and lesion humerus.METHODS:The low 1/3 of eighty human humeri were scanned by 16 layer spiral CT.The morphological features of the intramedullary bony prominence above the olecranon fossa was described in terms of coronal plane,sagittal plane and transverse section after three-dimensional reconstruction.The low 1/3 of twenty humeri were then split vertically in the middle line in coronal plane,to view the intramedullary bony crista directly.MAIN OUTCOME MEASURES:The bony crista mainly located on the medial or lateral side,the range of the bas'dar part of the bony crista,alinement characteristic of the bony crista.RESULTS:The extent of intramedullary bony crista ranged from 1.9 to 3.2 cm (mean 2.6 cm) above the olecranon fossa,the density similar to cortical bone,with an basement posterior,and medial part and lateral side intero-inferiody incline.59 out of the 80 humeri,medial side dorminated;on the rest humeri the lateral side dorminated.2 or 3 parallel lines on the dorminate side,irregular alignment on the other side.CONCLUSION:The study described the morphology of the distal intramedullary bony crista of the humerus,which has never been reported so far.In addition,its clinical relevance in terms of the internal fixation of fracture on the distal humerus and elbow arthroplasty was also demonstrated.

BACKGROUND: Cervical sympathetic ganglia block accelerates the re covery of the homeostasis of organic nervous-endocrine-immune system, butit is still unclear whether it can suppress the imbalance of homeostasis in duced by post-traumatic stress disorder. OBJECTIVE: To observe the effect of cervical sympathetic ganglia blockon the mortality of mice with combined radiation and burn injury, andwhether it can become an easy and effective method to treat secondarydamage after serious trauma. DESIGN: A randomized grouping design, an animal controlled experiment. SETTING: Department of Anesthesiology, Guangzhou General Hospital, Guangzhou Military Area Command of Chinese PLA.MATERIALS: The experiments were carried out in the Institute of Combined Injury, the Third Military Medical University of Chinese PLA between February 2004 and July 2005. Totally 160 Kunming mice were randomly divided into control group (n=50) and cervical sympathetic ganglia block group (n=50). In the control group, the mice were only induced to models of combined radiation and bum injury, and treated with injection of 0.3 mL saline at cervical part. In the cervical sympathetic ganglia block group, the mice were induced to models of combined radiation and burn injury, and then treated with cervical sympathetic ganglia block, once a day for 14 days continuously.METHODS: Methods to induce injury in the animals: ① Radiation injury: The mice were given even radiation of 60Coγ ray (5 Gy) at a distance of 1.5 m to the whole body, the rate of absorptive dosage was (5.17-5.33) mGy/s. ② Burn injury: After the radiation injury, coagulated gasoline was smeared on the back and burnt for 8 s to induce degree Ⅲ burn injury of 15% of the total body surface, which was proved by the pathological section. Methods of cervical sympathetic ganglia block: Cervical sympathetic ganglia block was given bilaterally, and then the mice were injected with 0.2 mL lidocaine (5 g/L), and it was observed whether the symptoms similar to Horner syndrome (hyperemia of conjunctiva, drooping eyelid,blushing, smaller eyeslit) occurred or not at 5 minutes after injection.MAIN OUTCOME MEASURES: The mortality at 2, 5, 7, 10, 20 and30 days after injury and the changes of the numbers of red blood cells,white blood cells and blood platelet in peripheral blood at 7, 14 and 21 days after injury were observed in both groups. The effects of cervical sympathetic ganglia block on the levels of tumor necrosis factor-alpha (TNF-α),interleukin-1β (IL-1β) and interleukin-6 (IL-6) in serum at 3, 6 and 14days after combined radiation and burn injury were also observed.RESULTS: All the 160 mice were involved in the analysis of results without deletion. ① Compared with the control group, the mortalities at 5,7, 10, 15, 20 and 30 days in the cervical sympathetic ganglia block group were significantly decreased [control group: 8%, 22%, 32%, 54%, 74%,82%, 90%; cervical sympathetic ganglia block group: 8%, 14%, 16%, 22%,28%, 34%, 56%]. ② Compared with the control group, the numbers of red blood cells, white blood cells and blood platelets in peripheral blood at 7,14 and 21 days after injury in the cervical sympathetic ganglia block group were significantly increased [at 21 days: red blood cells: 23.21×1012 L-1, 14.58×1012 L-1; blood platelet: 16.87×1011 L-1, 12.57×1011 L-1; white blood cells: 20.65×109 L-1, 14.58×109 L-1]. ③ The levels of TNF-α, IL-1β andIL-6 in serum at 3, 6 and 14 days after injury in the cervical sympathetic ganglia block group were significantly decreased as compared with those in the control group [at 14 days: TNF-α: 189, 365 ng/L; IL-1β: 14, 23 ng/L;IL-6: 70, 132 ng/L].CONCLUSION: Cervical sympathetic ganglia block can significantly decrease the mortality of animals with combined radiation and burn injury,and it is an easy and effective method to treat serious trauma, and the mechanism may be realized through accelerating the recovery of hematopoietic function and suppressing the excessive inflammatory reaction.

ObjectiveTo investigated the effects of Rhodiola Compound on improving the intellective function in mice and provide the basis for clinical application.MethodsMice were divided to different groups of three doses of rhodiola compound (0.3 g/kg,0.6 g/kg,1.2 g/kg) and swimming abilities were tested.Other mice were administrated single dose of compound rhodiola( 1.2 g/kg) and training by Morris water maze.Drug's improving intelligence function was assessed using memory acquisition impaired models made by scopolamine or alcohol.When the Morris water maze test was finished,mice were killed and brains were removed immediately to measure SOD and NO levels.ResultsGroups of three doses of compound rhodiola could significantly prolong the swimming time(P ＜ 0.05,P ＜ 0.01 ).Compound Rhodiola group can significantly reduce the swimming distance than the untreated group( ethanol model group:(26 906.6 ± 2769.7 ) mm,RCE treated group:( 19 586.1 ± 6826.7 ) mm ; P ＜0.05 ).Swimming distance and time of cross-platform quadrant was significantly increased,comparing with model group (P ＜ 0.05 ).Compound Rhodiola significantly enhanced the activity of mouse brain's SOD ( Scopolamine model group:( 150.3 ± 17.7 ) U/ml,RCE treated group:( 197.9 ± 16.8 ) U/ml ; P ＜ 0.05 ) and NO levels ( Scopolamine model group:( 44.7 ± 16.7 ) μmol/gprot,RCE treated group:( 65.4 ± 14.5 ) μmol/gprot ; P ＜ 0.05 ) significantly.ConclusionCompound Rhodiola could promote mice learning and memory function,SOD and NO in brain maybe play a important role in this effect.

It is currently reported that extracellular matrix, biological scaffolds, conditions of stress, nutrients and metabolic waste play very important roles in tissue-engineered osteochondral composite. In this paper, we have made a review of their effects on such composite.
Cartilage ; chemistry ; physiology ; Chondrocytes ; Connective Tissue ; growth & development ; Extracellular Matrix ; chemistry ; Humans ; Stress, Mechanical ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

Objective To determine the effect of reducing the value of mA or kV on the image quality and the radiation dose of the patients undergoing low-dose spiral CT for orthodontics.Methods Thirty patients were divided into three groups,each group has 10 patients.They were group 1(80 kV and 200 mA),group 2 (120 kV and 80 mA),group 3(120 kV and 200 mA)The volume CT dose index(CTDI)was recorded and the average dose-length produce(DLP)was calculated in three groups,respectively.Image quality of three groups were compared and scored by two radiologists,and the results were statistically analysed.Results The CTDI among three groups in diagnostic image quality.Conclusions Low-dose spiral CT for orthodontics,especially the low-kV scan,may decrease the radiation exposure and guarantee the image quality.

Objective To evaluate the reliability of gas sampling from the distal end of the tracheal tube for partial pressure of end-tidal CO2 (PETCO2) monitoring in neonates.Methods A total of 50 fullterm neonates,scheduled for elective abdominal surgery under general anesthesia,aged 1-28 days,weighing 2.55-4.00 kg,of ASA physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n =25 each) using a random number table:gas samples collected from proximal end of tracheal tube group (group P) and gas samples collected from distal end of tracheal tube group (group D).Epidural catheters of 1 mm in external diameter were used.One end of the catheter was connected to a tube for carbon dioxide sampling,and the other end was inserted into the endotracheal tube and advanced toward the distal hole of the tube.At 15 min of mechanical ventilation,blood samples were collected from the radial artery for record of PETCO2 and for blood gas analysis.Consistency test was performed between PETCO2 and partial pressure of arterial CO2 (PaCO2).Results PET CO2 was significantly lower than PaCO2 in the two groups.There was no significant difference in PaCO2between the two groups.PETCO2 was significantly higher in group D than in group P.Kappa was significantly higher in group D than in group P.Conclusion Gas sampling from the distal end of the tracheal tube is more reliable than gas sampling from the proximal end in monitoring PETCO2 in the neonates.

OBJECTIVETo investigate the effect of benzo[a] pyrene(BaP) on DNA damage and expression of genes involved in nucleotide excision repair[xeroderma pigmentosum group B, C, G(XPB, XPC, XPG) and excision repair cross-complementing 1 (ERCC1)] in lung cancer A549 cells.

METHODSCell survival was measured using MIT metabolic viability assay. Single cell gel assay was applied to determine the DNA damage and repair. The level of gene expression was measured by reverse transcription-polymerase chain reaction.

RESULTSThe cell survival decreased from 95.0% to 70.0% after 24 h treatment with BaP of varying concentration ranging 0.625-20.000 mumol/L. The cell survival decreased to 87.0% and 73.0% respectively after 12 h and 24 h treatment with 10 mumol/L BaP, with DNA damage gradually elevated. At 12 h after 24 h treatment, the cell survival further decreased to 59.0% and DNA damage became most serious. At 24 h after 24 h treatment, cell survival recovered to 71.0%, and damaged DNA was repaired gradually. XPB and XPC gene expression increased to 4.5-fold and 11.2-fold respectively compared with basal level at 24 h treatment or 12 h after 24 h treatment with 10 mumol/L BaP respectively. However, ERCC1 and XPG gene expression was inhibited in 24 h treatment period, then recovered gradually after treatment.

CONCLUSIONBenzo[a]pyrene could lead to DNA damage and expression level change of genes involved in nucleotide excision repair in lung cancer A549 cells.

Benzo(a)pyrene ; toxicity ; Cell Line, Tumor ; Cell Survival ; DNA Damage ; DNA Repair ; DNA-Binding Proteins ; genetics ; Endonucleases ; genetics ; Humans ; Lung Neoplasms ; genetics

Objective To evaluate the efficacy and safety of "outside-in" arthroscopic cam resection in the treatment of femoroacetabular impingement (FAI)syndrome.Methods Nine patients were treated with "outside-in" hip arthroscopy for cam or mixed type FAI syndrome between July 2015 and July 2016.All the 9 patients(11 hips)underwent osseous correction of the femoral neck and labral debridement.Before the surgery and 12 months after it,all patients were evaluated using the Harris Score and their complications were observed.Results The average postoperative Harris Score(92.5,range from 64 to 100)was significantly better compared with the preoperative one(56.4,range from 22 to 70,P＜ 0.001).One patient with blister on dorsal foot and another with fluid leakage were cured.No neurovascular injuries or cartilage injuries were found among all the patients.Conclusion "Outside-in" arthroscopic treatment of FAI with osseous correction and labral debridement is safe and effective.