The accidental displacement of tooth roots into the mandibular canal is a serious complication during tooth extractions in oral and maxillofacial surgery, often resulting in direct damage to the structural and functional integrity of the inferior alveolar neurovascular bundle (IANB). This article reviews the anatomical features of the mandibular canal, the IANB, and adjacent tooth roots; identifies high-risk factors and anatomically vulnerable sites for root displacement; and outlines the clinical manifestations and radiographic characteristics of intraoperative root intrusion into the mandibular canal. Furthermore, management principles, surgical approaches and techniques, inferior alveolar nerve injury treatment, and prognostic considerations are discussed. The aim of this review is to provide a comprehensive clinical reference for improving surgical outcomes, and reducing postoperative complications.
Humans ; Tooth Extraction/adverse effects* ; Mandible/surgery* ; Tooth Root ; Mandibular Nerve/anatomy & histology* ; Postoperative Complications/prevention & control* ; Intraoperative Complications ; Mandibular Nerve Injuries/etiology*

Objective To investigate the results and complications of hemispherotomy for drug resistant hemispheric epilepsy.Methods The authors reviewed 5 patients who were diagnosed as drug resistant hemispheric epilepsy and operated in the neurosurgery department of Peking Union Medical College Hospital from 2011 to 2013.All the 5 patients were underwent hemispherotomy after carefully multidisciplinary pre-operation evaluation.Results All patients tolerated the procedure well and the postoperative course was smooth.All the 5 patients didn`t have seizure in the period of following up of 46 to 69 months.Conclusions According to literatures and the authors` experience, hemispherotomy is as safe and efficient for hemispheric epilepsy as hemispherectomy.It is most important advance for hemispherectomy.The procedure of hemispherotomy is complex but not very difficult, illustrating a good prospect of application and extension.

Objective To compare the anesthesia effects of sevoflurane and propofol in extensive hysterectomy patients and the influence on cognitive function.Methods 94 patients of extensive hysterectomy were selected,according to the drawing method they were divided into control group and observation group,47 cases in each group,the patients were given propofol or sevoflurane anesthesia respectively.The postoperative mini-mental state examination(MMSE) score and the incidence of cognitive dysfunction,inflammation factors,stress reaction,hemodynamic,anesthetic effect and complications were observed in the two groups.Results After operation,the MMSE score of the observation group was higher than that of the control group[(25.44±3.18)points vs.(23.96±2.93)points](t=2.346,P=0.021),the incidence rate of cognitive dysfunction in the observation group was lower than that of the control group [2.12%(1/47) vs.12.76%(6/47)],there was satistically significant difference between the two groups(χ2=3.858,P=0.049 5).The inflammatory factors,stress reaction and hemodynamic index of the observation group were better than those of the control group(all P<0.05).The spontaneous breathing recovery time,open time,extubation time of the observation group were less than those of the control group [(6.19±0.77)min vs.(8.75±1.09)min,(6.89±0.86)min vs.(9.36±1.17)min,(9.47±1.18)min vs.(11.26±1.43)min],there were satistically significant differences between the two groups(t=13.150,11.661,6.619,P=0.000,0.000,0.000).The complication rate had no difference between the two groups(P>0.05).Conclusion The effect of sevoflurane on cognitive function in patients with extensive hysterectomy is less than propofol,and the anesthesia effect is more precisely.

OBJECTIVE:To study the chemical constituents of Sedum lineare. METHODS:Silica gel column chromatogra-phy,TLC and crystallization were adopted to isolate the chemical constituents of S. lineare. And chemical structures were analyzed and identified based on physicochemical properties and spectral data of compounds. RESULTS:A total of 6 sterols and 2 triterpe-noids were isolated from petroleum ether fraction of S. lineare,which were identified as stigmaster-5-ene-3β-ol-7-one(1),stigmas-ter-5-ene-3β,7α-diol(2),daucosterol(3),daucosterol palmitate(4),β-sitosterol(5),stigmaster-7-ene-3β-ol(6),δ-amyrin(7),andδ-amyrone(8)respectively. CONCLUSIONS:Compounds 3,4 and 7 are isolated from S. lineare for the first time,and compound 4 is isolated from genus S.lineare for the first time. The study has laid certain foundation for the quality evaluation of S. lineare.

Objective To describe the changing demographic profile over time of pregnant women diagnosed with HIV infection, and trends in mode of delivery and pregnancy outcome. Methods An observational investigation was conducted based on a population of 1 128 HIV-positive pregnant women at eight sites in China in provinces with high prevalence of HIV among pregnant women and children between 2007 and 2013. The study area included Shangcai and Weishi counties in Henan province; Ruili and Longchuan counties and Linxiang prefecture in Yunnan province;Yining County in Xinjiang;and Lingshan county and Babu district in Guangxi province. Main outcome measures were maternal characteristics, mode of delivery, and related trends over time by Cochram-Mantel-Haenszel(CMH) χ2-test. Results A total hospital delivery rate of 96.4%was reported. For each year during the period 2007-2013, hospital delivery rates were 95.1%(253/266), 94.8%(188/198), 93.7%(164/175), 98.8%(159/161), 98.6%(141/143), 97.4%(114/117), and 100.0%(68/68), respectively (χ2CMH=7.68, P=0.006). The neonatal survival rate increased by 0.7% incrementally from 2007 to 2013, with 98.5% (262/266), 99.0% (196/198), 99.4% (174/175), 99.4%(160/161), 100.0% (143/143), 100.0% (117/117), and 100.0% (68/68), respectively (χ2CMH=4.58, P=0.030). The proportions of vaginal deliveries in those years were 62.2% (166/266), 54.8% (109/198), 59.9% (105/175), 61.7% (100/161), 66.7% (96/143), 58.8% (69/117), and 66.7% (46/68), respectively (χ2CMH=1.19, P=0.276). The average rate for midwives skilled in procedures such as artificial rupture of membranes and episiotomy was 37.8% (261/691), with proportions decreasing during the study period at 39.2% (65/166), 47.4% (52/109), 35.9% (38/105), 46.0% (46/100), 25.5% (25/96), 31.2% (22/69), and 28.3% (13/46), respectively (χ2CMH=6.76, P=0.009). Conclusion The annual rate of reported hospital delivery increased between 2007 and 2013, with a declining rate of skilled midwifery over the same period. Survival of neonates born to HIV-infected mothers in China has increased to nearly equivalent levels as those of developed countries.

Objective To describe the changing demographic profile over time of pregnant women diagnosed with HIV infection, and trends in mode of delivery and pregnancy outcome. Methods An observational investigation was conducted based on a population of 1 128 HIV-positive pregnant women at eight sites in China in provinces with high prevalence of HIV among pregnant women and children between 2007 and 2013. The study area included Shangcai and Weishi counties in Henan province; Ruili and Longchuan counties and Linxiang prefecture in Yunnan province;Yining County in Xinjiang;and Lingshan county and Babu district in Guangxi province. Main outcome measures were maternal characteristics, mode of delivery, and related trends over time by Cochram-Mantel-Haenszel(CMH) χ2-test. Results A total hospital delivery rate of 96.4%was reported. For each year during the period 2007-2013, hospital delivery rates were 95.1%(253/266), 94.8%(188/198), 93.7%(164/175), 98.8%(159/161), 98.6%(141/143), 97.4%(114/117), and 100.0%(68/68), respectively (χ2CMH=7.68, P=0.006). The neonatal survival rate increased by 0.7% incrementally from 2007 to 2013, with 98.5% (262/266), 99.0% (196/198), 99.4% (174/175), 99.4%(160/161), 100.0% (143/143), 100.0% (117/117), and 100.0% (68/68), respectively (χ2CMH=4.58, P=0.030). The proportions of vaginal deliveries in those years were 62.2% (166/266), 54.8% (109/198), 59.9% (105/175), 61.7% (100/161), 66.7% (96/143), 58.8% (69/117), and 66.7% (46/68), respectively (χ2CMH=1.19, P=0.276). The average rate for midwives skilled in procedures such as artificial rupture of membranes and episiotomy was 37.8% (261/691), with proportions decreasing during the study period at 39.2% (65/166), 47.4% (52/109), 35.9% (38/105), 46.0% (46/100), 25.5% (25/96), 31.2% (22/69), and 28.3% (13/46), respectively (χ2CMH=6.76, P=0.009). Conclusion The annual rate of reported hospital delivery increased between 2007 and 2013, with a declining rate of skilled midwifery over the same period. Survival of neonates born to HIV-infected mothers in China has increased to nearly equivalent levels as those of developed countries.

Objective To investigate the development of early myocardial perfusion with myocardial contrast echocardiography (MCE) combined with dipyridamole stress echocardiography in diabetic rats . Methods The diabetes mellitus (DM) group comprised 40 male diabetic rats ,induced with streptozotocin . The control group comprised 40 normal male rats ,comparable body weights with the DM group .The DM group was divided into four subgroups (0 week ,2 weeks ,4 weeks and 8 weeks after diabetic model established) and the control group was also divided into four subgroups matched with the DM group .Each rat was performed with conventional echocardiography ,MCE at baseline and after dipyridamole stress .The reserve parameters were compared between the control group and the DM group .In addition ,the differences among four subgroups in the control group and the DM group were compared ,respectively .Results MCE demonstrated that the 4 weeks and 8 weeks DM subgroup had lower myocardial blood velocity reserve and myocardial blood flow reserve than the control subgroup .The myocardial blood volume reserve was reduced in the 8 weeks DM subgroup ,too .Conclusions The impairment of myocardial perfusion in the DM rats are detected earlier with the MCE combined with dipyridamole stress .

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Objective To study the role of the transforming growth factor-β-activating kinase 1 (TAK1) poly-ubiquitination in radiation-induced NF-κB activation.Methods FLAG-TAK1 and HA-UbK63 plasmids were transiently transfected into HEK-293T cells.The radiation effect on TAK1 ubiquitination was detected by immunoprecipitation and Western blot,which was further confirmed in FLAG-TAK1 HeLa stable cell line.Results At 1 h after irradiation,Lys 63-1ink TAK1 ubiquitination was induced in the HEK-293T cells with plasmids transfection.This result was further confirmed by using a FLAG-TAK1 stably expressed HeLa cell line.Radiation-induced IKKs and p38 phosphorylation were greatly impaired in MEFs reconstituted with TAK1 K158R mutant compared to ones with wild-type TAK1.Conclusions Lys63-1inked TAK1 poly-ubiquitination at Lys-58 plays a key role in the process of radiation-induced NF-κB activation.

Objective To investigate the common types of fetal cardiac malformations and complicated malformations,and to assess the value of classifying on these types.Methods 3201 pregnant women were undergone with fetal echocardiography (FECG),239 fetuses of them were diagnosed to be suffered with congenital heart disease(CHD),and 8 cases were one of twins with abnormal heart confirmed by FECG.All new-births were examined by echocardiography within half year after their births.Results 155 complex CHD in 239 fetuses were diagnosed by FECG,in them the common malformations were in turn 59 cases with diagnosed univentricular heart,29 cases with double outlet right ventricle,19 with atrio ventricular septum defect,12 with tetralogy of Fallot or quinalogy of Fallot,11 with persistent truncus arteriosus,6 with right ventricular dysplasia syndrome,6 cases transposition of the great vessels.100 cases were induced labor,41 of them were comfirmed by pathology.16 fetuses were born,123 cases were being pregnanted or un-followed up.Conclusions Complex and multi-malformation were common in fetal cardiocascular abnormalities.Diagnosing rate of fetal CHD(FCHD) in our enroll fetuses was 7.47 ％,rate of complex CHD vs CHD was 64.85 ％.According different types of FCHD,able to be operated or not after birth,surgery methods,as well as prognosis evaluations,all FCHD cases were classified into three subtypes:curable type,curable palliative type and untreatable type.This newly viewpoint will help pregnant women and their family to make reasonable selection.