Clinicopathological characteristics and prognosis analysis of mucinous tubular and spindle cell carcinoma of the kidney / 中华泌尿外科杂志

Objective:To explore the clinicopathological features and prognosis of renal mucinous tubular spindle cell carcinoma (MTSCC).Methods:The clinical data of 16 patients with MTSCC admitted to the First Affiliated Hospital of Zhengzhou University from July 2013 to July 2022 were retrospectively analyzed. There were six male cases and ten female cases. The mean age was (56.4±11.4) years old. Among them, 10 cases were asymptomatic, two complained of hematuria, three complained of lumbar pain, and one complained of lower limb pain. Twelve cases underwent preoperative enhanced CT examination, 6 cases of ultrasound examination, 3 cases of MRI examination, and 1 case of bone scan. Imaging manifestations showed that the masses were round or round-like with clear borders. Two cases combined with hemorrhage and three cases combined with calcification. Five cases showed exophytic growth, 10 cases partially exophytic, and 1 case completely endophytic. The maximum diameter of the tumor was (65.7±27.4) mm. The tumors were located in the left kidney in 11 cases and in the right kidney in 5 cases. The tumors were mildly delayed-enhancing under enhanced CT, long/short T1 signal mixed with long/short T2 signal under MRI, and diffusion-limited high signal under DWI. The tumors were hypoechoic masses without obvious blood flow signals under ultrasound. Twelve cases were diagnosed as renal occupying neoplasms, 2 cases were suggested as lack of blood supply renal tumor, and one was considered renal tumor rupture and bleeding. In one case, a bone scan suggested metastasis to the thoracic spine and pelvis. The metastatic renal tumor was diagnosed, and a renal puncture was performed to clarify the pathology. Eleven patients underwent laparoscopic radical nephrectomy, and 4 patients underwent partial nephrectomy. One case was metastasized without surgery and treated with apatinib mesylate and zoledronic acid.Results:The postoperative pathological specimens showed grayish, grayish-yellow, or grayish-red masses with a soft or medium texture. No perinephric, ureteral, or adrenal invasion was seen in all tumors. Microscopically, the tumor cells were round and ovoid. The tumor cells were arranged in tubular and striated shapes, and mucus pools were locally visible. No sarcomatous component was seen in all tumors. There were 9 patients with pT 1N 0M 0, 6 patients with pT 2N 0M 0, and 1 patient with pT 1N 0M 1. After operation, 2 patients with pT 2N 0M 0, who underwent laparoscopic radical nephrectomy were treated with pazopanib and sunitinib, respectively. All patients were followed up for a median of 50.7(25.8, 75.0)months, 15 patients were free of recurrent metastases, and 1 patient with pre-puncture metastasis died due to tumor progression of multiple pulmonary and bone metastases, with a survival of 16.9 months. Conclusions:Renal MTSCC is rare, mostly found on physical examination, with female patients predominantly, and imaging shows a lack of blood supply tumor. Surgery is the primary treatment method. Partial nephrectomy or radical nephrectomy could be chosen according to the tumor stage, kidney function, and patient's underlying condition, and patients have a good prognosis.

Eye socket reconstruction in patients with severe depressed eye socket combined anophthalmos / 中华医学美学美容杂志

Objective To summarize the effect of eye socket reconstruction in patients with severe depressed eye socket combined anophthalmos and to assess the methods of eye socket reconstruction.Methods Forty patients of severe depressed eye socket combined anophthahnos,from Oct,2001 to Mar,2014,underwent eye socket reconstruction in Beijing Tongren Hospital.Thirty four eye sockets were reconstructed with free flap,the scapular flap in 2 cases,the forearm flap in 17 cases,the lateral arm flap in 15 cases.The reversed submental island flap was utilized in 2 patients.The other 4 cases were treated by implant-retained orbital prosthesis.Results All the patients were followed up for more than 2 years.The flaps survived.The artificial eye could be fitted satisfactorily and the appearance of the ill eye socket was improved significantly.The implant-bodies in orbital bone and the prosthesis were stable without peri-implantitis.Conclusions The flap transfer is effective for eye socket reconstruction in patient with severe depressed eye socket combined anophthalmos.The implant-retained orbital prosthesis is also alternative.The treatment choice must be based on the patient 's own conditions.

Application of a computer-assisted navigation system (CANS) in the treatment of complicated orbital fractures / 中华医学美学美容杂志

Objective To evaluate the effectiveness of computer-assisted navigation system on open reduction as treatment for complicated orbital fractures.Methods The computed tomography (CT) data for 6 patients with complicated orbital fractures were obtained before surgery and imported into the surgical planning software.After 3-dimensional (3D) construction and segmentation,data from the unaffected side were used to guide the reduction data,and surgical simulation was performed.All patients underwent open reduction under the guidance of the navigation system.The segments were then reduced to the predetermined places.CT measurements were used to evaluate navigation accuracy and bone symmetry.Results A fairly accurate match between the intraoperative anatomy and the computed tomography images was achieved through registration,with a systematic error of 1 mm difference.With guidance of the navigation system,open reduction of fractures was performed in all cases.The reduction was checked by postoperative computed tomography scans,with a good match with preoperative planning noted.The maximal deviation between the reduction and preoperative planning was less than 2 mm.The postoperative facial appearance of the patients was clearly improved.Conclusions Navigation-guided open reduction of complicated orbital fractures can be regarded as a valuable treatment option for this potentially complicated procedure.

Research on effects of preheating on the mechnical properties of two resin composites / 中国医学装备

Objective:To investigate the effect of preheating on the microhardness and compressive strength of two resin composites. Methods: Specimens were fabricated from one microhybrid composite resin(Filtek Z250, 3M ESPE, St. Paul, MN, USA)and one nanohybrid composite resin (Filtek Z350, 3M ESPE, St. Paul, MN, USA), and stored at two different temperature(23℃, 40℃). The microhardness and compressive strength were tested after cured. Data obtained were analyzed using two-way analysis of variance. Results:For two composites, the preheated specimens have higher microhardness and compressive strength value than that stored at room temperature. Conclusion:Preheating can improve the mechnical properties of resin composite.

Reconstruction of severe atresic eye socket with lateral arm free flap / 中华显微外科杂志

Objective To study the method and effect of lateral arm free flap in reconstruction of severe atresic eye socket.Methods Forteen cases of severe atresic eye socket,from June,2011 to June,2013,were repaired by lateral arm free flap.The flaps were designed and harvested as drop shape with size about 6 cm × 10 cm and then were removed epidermis except distal 6 cm × 6 cm area which were transferred to orbit for eye socket reconstruction.The remaining fascia and dermis were filled to augment temporal defect.Superficial temporal artery was anastomosed with posterior branch of radial collateral artery in 14 cases and superficial temporal vein was anstomosed with radial collateral vein in 11 cases,with middle temporal vein in 3 cases.Results All 14 cases lateral arm free flaps survived with no donor site morbidity.Followed up for 1 year to 3 years,artificial eye could be fitted satisfactorily and temporal contour improved.Conclusion Lateral arm free flap is a recommendable option for severe atresic eye socket reconstruction because of concealed donor site scar,proper volume,matched vascular caliber and minor donor site morbidity.

Digital guide plates for correction of unilateral delayed orbitozygomatic complex fractures / 中华创伤杂志

Objective To investigate the clinical outcome of correction of unilateral delayed orbitozygomatic complex fractures with digital guide plates.Methods The study involved 14 cases of unilateral delayed orbitozygomatic complex fractures treated between September 2007 and March 2012.Craniofacial structures were measured by thin-section CT before operation,followed by data input to the image processing software.Before and after the processing of images,three dimensional skull models were produced using rapid prototyping technique and applied to have surgical simulation.Digital guild plates were produced for guiding the reduction of fractures and orbital walls were reconstructed as well.Results All cases were followed up for a period of 6-11 months,which showed basic restoration of facial structure and significant correction of diplopia and enophthalmos,with no infection or dislocation of implants buried in orbit floor.Mild ectropion of the lower eyelid occurred in one case and temporary decrease of frontal wrinkle in two cases,but all recovered in 3-6 months postoperatively.Conclusion Digital guide plate is easy in operation and reliable for treatment of unilateral delayed orbitozygomatic complex fractures.

Effects of anisodamine on neurological functional status of cerebral resuscitation: a systematic review and meta-analysis / 中华急诊医学杂志

Objective To evaluate the clinical effects of Anisodamine on neurological function as well as the safety of using it after cerebral resuscitation. Methods The data of CNKI (from January 1979 through January 2011 ) and Pubmed (from January 1978 through January 2011 ) were searched.The Cochrane Library was applied for identifying randomized controlled trials (RCTs) about effects of Anisodamine on neurological function after cerebral resuscitation.The methodological quality was assessed and the data were collected according to the criteria defined in Cochrane Reviewer' s Handbook for meta-analyses with RevMan 5.0.25 package.Results Data of 327 patients from 4 eligible studies were included in this analysis.The results of meta-analyses showed that Anisodamine used after cerebral resuscitation improved Glasgow coma scale (GCS) in the early stage [ MD =1.4,95％ CI (0.98,1.82),P ＜0.01 ] and lessen neurological deficit (ND) in the later stage [ MD =-4.38,95％CI ( -5.26, -3.51 ),P ＜0.01 ].Meanwhile,the reduction of long-term ND of patients was documented in two studies ; the improvement of ability of daily life of patients in 2 ～ 3 months after anisodamine used was reported in two studies; the improvement of patients' quality of life (QL) was recorded in one study and the inhibited release of excitatory amino acid (EAA) was reported in one study.All eligible studies did not report any serious adverse effects of Anisodamine used after cerebral resuscitation. Conclusions Anisodamine used after cerebral resuscitation can improve patients'status of neurological function with relative safety of administration.

Radiographic Analysis of Peri-implant Alveolar Bone Loss / 中国康复理论与实践

@#Objective To analyze peri-implant alveolar bone loss with radiography. Methods 38 implants were inserted in 27 cases. The peri-implant alveolar bone was observed and measured with intraoral radiography at time of insertion, functional loading, and 3, 6, 12 months after functional loading. Results The mean peri-implant alveolar bone loss was 0.35 mm immediately after functional loading, 0.57 mm, 0.67 mm,1.01 mm at 3,6,12 months later. There was not significant difference of bone loss between maxilla and mandible, neither of submerged and non-submerged implants. ITI implants performed significantly less bone loss than Replace Select within 3 months after functional loading (P<0.01). Conclusion Osseointegration will successfully be obtained on implants involved. The peri-implant alveolar bone loss with ITI is less than that with Replace Select. The bone loss is not different between submerged and non-submerged implants.

Surgical repair of medial orbital wall combined with orbital floor fracture via lower lid subciliary approach / 眼科

Objective To assess the effect of surgical repair of medial orbital wall combined with orbital floor fracture via lower lid subciliary approach. Design Retrospective case series. Participants 18 cases of medial orbital wall combined with orbital floor fracture. Methods All patients underwent the reconstruction of orbital wall via lower lid subciliary approach. The composite hydroxyapatite was implanted into the surface of medial orbital wall and orbital floor after lacriminal cyst was completely dissected and protected during the operation. Orbital axial and coronal CT, three-dimension CT scan have been used in all the cases preoperalively and postoperatively. Preoperative CT was compared with postoperative CT. Main Outcome Measures Clinical symptoms and complications. Results All patients were followed up for 3 to 18 months. The postoperative scar of infracillary skin was not obvious. The composite hydroxyapatite was not rejected and dislocated in all cases postoperatively. No postoperative epiphora was found in either case. Preoperative diplopia and enophthalmos were corrected. Conclusion The treatment of medial orbital wall combined with orbital floor fracture via an isolated lower lid subciliary approach was feasible. But the incision was only used in the treatment of inferior medial orbital wall combined with orbital floor fracture, especially the transition area fracture between the orbital floor and medial orbital wall.

Analysis of 114 cases of orbital fractures / 实用口腔医学杂志

Objective: To investigate the principle of diagnosis and treatment of orbital fracture. Methods:114 cases of orbital fractures were reviewed. The incidence of major clinical feature was estimated and the surgical procedures were analyzed. Results:Incidence rate of restricted ocular motility, diplopia and enophthalmos were 63.2%, 62.3% and 59.6% respectively; The incidence of optic nerve injury, lacrimal injury and rupture of the globe was 15.8%,15.8% and 12.3% respectively. 95.6% of the cases were undergone orbital wall reconstruction (artificial bone graft) and 72.8% were received fracture reduction and internal fixation. Conclusion:Restricted ocular motility, diplopia and enophthalmos are major symptoms of orbital fracture and optic nerve injury, lacrimal injury and rupture of the globe are important complications of orbital fracture; Orbital reconstruction is the most popular surgical procedure for orbital fracture and bone reduction and internal fixation is also need for impure orbital fracture.

Treatment of sagittal maxillary fractures / 实用口腔医学杂志

Objective:To evaluate the technique of reduction and rigid internal fixation of sagittal maxillary fracture. Methods:15 cases of sagittal maxillary fracture were reviewed. Occlusal guide plates were prepared preoperatively by model surgery analysis in 10 cases; Le Fort ? osteotomy and down-fracture were done in 8 cases; Pterygomaxillary junctions were also separated in the other cases. Internal fixation was applied along the anterior maxillary surface by using microplates in all 15 cases. Results:Anatomically reduction was achieved in all cases; Occlusion of 14 cases was corrected except one case of fracture re-displaced. Conclusion:Orthognathic technique is effective treatment of sagittal maxillary fracture; One microplate applied along anterior maxillary surface may be not enough to ensure the fixation of sagittal maxillary fracture.

Remineralization of soft dentin by glass ionomer cement / 实用口腔医学杂志

Objective: To evaluate the remineralizing effe ct of glass ionomer cement (GIC),calcium hydroxide(Dycal)and zinc phosphate ceme nt on soft dentin. Methods:Standard cavity of 1 mm?2 mm was pre pared on each of the 60 premolars extracted for orthodontic treatment. The teeth were randomly divided into three groups with 20 in each after demineralization ,the cavities were blocked by GIC, Dycal and zinc phosphate cement respectively and filled with zinc oxide. All the teeth were dipped in man-made saliva for 3 0 days.Then the samples were sectioned, microradiographied and the mineral conte nt were determined by microdensitometry. Results:The remineraliz ing rate in the group of GIC, Dycal and zinc phosphate cement was 31.22%,13.19 % and 8.92% respectively (P