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Objective: To evaluate the effect of venous anastomosis by using microvascular coupler during repair and reconstruction surgery after recection of tumor in oral and maxillofacial area. Methods: 20 patients with oral and maxillofacial tumor were chosen for repair of the defects via free flap. Microvascular coupler was applied to combine venous system,however,traditional methods were used in arterial anastomosis. Results: The average time of venous anastomosis using microvascular coupler was (5. 75 ± 0. 53) min,none of the cases were suffered from thrombosis after surgery. Vascular nerosis resulted from arterial spasm occured in 1 flap,reaching the flap survival rate of 95％(19 /20). Neck bleeding occurred in 1 case after surgery,the reflux of the anastomosed vein went smoothly when the blood clot was cleared,flap healing was unaffected. In another case,the coupler released during the surgery due to thick blood vessel wall as well as hypertension among the anastomotic edge,the vessels were manually sutured. Conclusion: With the appropriate indications, application of microvascular coupler may shorten the operating time,without affecting the effect of vascular anastomosis. The possibility of coupler loosing should be alarmed when bumped into great anastomotic tension or thick wall of the vein.
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Objective:To test curriculum management effect of graduate students'clinical practice of counseling psychology.Methods:Totally 26 students [average age (24.5 ± 1.0) years] who completed 30-day interns summer were investigated with the self-made questionnaire evaluating the quality of clinical practice.Results:All students obtained promotion in practice activities,the attendance ranged from 50.0％ to 96.2％.The overall satisfaction was (3.8 ± 0.8) and the average degree of supervisors'satisfaction was (4.0 ± 0.8).There were 92.3 ％ of the students had participated more than 224 hours' practice and completed all tasks.After the interns,the students had significantly improved in all 8 aspects of professional abilities.Conclusion:In graduate education of counseling psychology,curriculum management of clinical practice may be an effective approach to improve students' clinical skills.
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Objective There are quite a few chemotherapeutic adjuvants for the treatment of advanced oral squamous cell carcinoma, but all have their adverse effects. This study was to evaluate the efficacy and adverse effects of the induction chemotherapy of S?1 plus docetaxel and cisplatin in the treatment of advanced oral squamous cell carcinoma. Methods Totally, 84 patients with advanced oral squamous cell carcinoma were randomly divided into an observation and a control group of equal number, the former trea?ted with S?1 plus docetaxel and cisplatin and the latter with 5?fluorouracil, docetaxel and cisplatinand, both for two cycles ( 1 cycle =21 d) . Then the effects and adverse events were evaluated and compared between the two groups of patients. Results No statistically significant differences were observed in the response rate between the observation and control groups of patients (76.19% vs 73.81%, P>0.05). The incidence rates of adverse events, such as nausea and vomiting (66.67% vs 88.10%, P<0.05) and phlebitis (0 vs 19.05%, P<0.05) , were remarkably lower in the former than in the latter group. Conclusion S?1 plus docetaxel and cisplatin is a reli?able induction chemotherapy with few adverse effects in the treatment of advanced oral squamous cell carcinoma.
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BACKGROUND: Microwave had been widely used in medical field, which can lead to local coagulation necrosis and repair the necrosis with fibrous tissue. However, whether microwave coagulation can be used in stomatology is poorly understood.OBJECTIVE: To observe the functional and volumetric changes of skeletal muscles following microwave coagulation, and to explore the possibility of microwave coagulation for volumetric reduction of skeletal muscle.METHODS: Both sides of tibialis anterior muscle of 20 New Zealand rabbits were exposed; one side was coagulated by 2 450 MHz microwave therapeutic instrument at 70 W for 20 seconds. No treatment was performed at the other side. Rabbits were sacrificed at hours 24, 48, weeks 1 and 8 after microwave coagulation. The volumetric changes of the ablated tibialis anterior muscle were measured, and electricitic physiology observations were conducted on the ablated muscle at 8 weeks after microwave coagulation before being sacrificed.RESULTS AND CONCLUSION: The volume of ablated muscle increased at hours 24 and 48, which was (5.82±0.93) and (6.04±0.47) mL, especially greater at hour 48 after microwave coagulation. After 1 week, the muscle volume began to decrease to (4.90±0.80) mL, reduced to (4.27±0.67) mL at week 8, which was 23.6% volumetric loss. However, the electrophysiologic observation showed that the latent periods were (1.765+0.393) and (1.760±0.394) ms, and the wave width was (6.273±0.808)and (6.259±0.773) ms of the control group and experimental group, respectively, without apparent differences (P ＞ 0.05). The volume of the skeleton muscle increased at hour 48 after microwave coagulation, and then decreased, but the muscle function of the skeleton muscle can be preserved.
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Objective:To observe the morphological changes in skeletal muscles after therapeutic. Methods:Tibialis anterior muscles of 25 New Zealand rabbits were exposed and coagulated with 70 W for 20 s. The rabbits were sacrificed at 1 hour?24 hours?48 hours?1 week and 2 months after MCT. The specimens of coagulated areas were prepared for histological observation. Results:Obvious rims could be found bet ween coagulated and normal tissues .The ablated site showed tissue fixation in the inner zone and coagulative necrosis in found the outer zone.these were four zones can be seen under high powered magnification:the application zone,the central zone,the transition zone and the reference zone. Demarcation zone of necrosis appeared 24h after MCT. Tibrosis encapsulation occurred after 7 days.Replacement with fine cicatrix was demonstrated after 2 months. Conclusion:Tissue destroyed by coagulation can be replaced with a fine cicatrix gradually.