Small incision through the tragus for the treatment of sagittal condylar fracture / 口腔疾病防治

Objective@#The purpose of this study was to a new operative approach for sagittal condylar fractures via a preauricular small incision-based technique and to examine the effectiveness of this approach. @*Methods@#Fifteen patients (19 sides) with sagittal condylar fractures were included in the study. The incision length was approximately 4 cm through the tragus, exposing the superficial temporal vessels, which was then pulled forward. Next, the deep temporal superficial fascia was cut, and the surface of the zygomatic arch and the articular capsule of the temporomandibular joint were exposed. Joint capsule incision was performed, with mandibular condylar fracture fixation under direct vision. We followed up with the patients postoperatively for 6 months with clinical and radiographic examinations. @*Results @#All patients had 1 week postoperation before being discharged, during which 2 cases of mild facial paralysis (with lateral temporal level Ⅱ facial paralysis, with lateral temporal branch level Ⅲ facial paralysis and level Ⅱ zygomatic branch of facial nerve paralysis after treatment) were observed, after given nerve nutrition agents, 2 cases returned to normal within 3 months. No patient exhibited a postoperative delayed fistula infection or other serious complications. Intraoperative occlusion relationships recovered well, and postoperative CTs suggested that the fracture ends and condyles were in good condition. The occlusion relationship was normal for 3 months after surgery, with a degree of opening greater than 30 mm, no play in the joints and no oblique openings being observed, and reexamination 6 months after the surgery revealed no obvious scars.@*Conclusion@#This surgical method involves a small incision and clear anatomic structures and avoids damage to the facial nerve. This method provides better surgical vision for treatment of sagittal condylar fractures, is safe and convenient, and deserves clinical recommendation.

Learning the new by restudying the old: discussion on "consolidating tendons when tendons involved in disorders" / 中国针灸

In order to better understand and implement the treating principle of acupuncture as "consolidating tendons when tendons involved in disorders", the author explored the necessity of this principle in view of "the depth of disorder and depth of needle insertion" through explaining the meanings of it in the classic literature. In combination with the clinical experience, three recognitions were proposed. When treating tendon disorder, the correct recognition of disease is very important. The coordination of points and the distal points enhances the therapeutic effects. Besides, the modern anatomic knowledge is assisted to the selection of acupoints. The study results enrich the connotation of this treating principle, explore the approach to the clinical treatment of the disorders of bones, joints and soft tissues and improve the therapeutic effects.

Application research of adjacent anatomic structure of lower cervical pedicle / 局解手术学杂志

Objective To provide data support for safe and accurate lower cervical pedicle screw implantation by observing the lower cervical pedicle and its relationship between the adjacent spinal cord, endorhachis, nerve root and vertebral artery, particularly its relation-ship between the endorhachis and epidural sinus. Methods Measured the C3 ~ C7 cervical sample of 32 adult with vernier caliper and pro-tractor, including the distance between cervical pedicle and its upper and lower nerve root, the distance between cervical pedicle and en-dorhachis, the distance between cervical pedicle and vertebral artery, and the distance between cervical pedicle and epidural sinus. Results The distance betweencervical pedicle and its upper nerve root was 1. 18~1. 40 mm, the distance between cervical pedicle and its lower nerve root was 2. 33~3. 11 mm;the distance between cervical pedicle and endorhachis was 2. 75~3. 33 mm;and there was nearly no distance be-tween cervical pedicle and vertebral artery and epidural sinus. Conclusion Cervical pedicle has a very close relationship with spinal cord, endorhachis, vertebral artery and nerve root, and the cervical pedicle is narrow and small. Therefore, it requires fully assess accroding to in-dividualization so as to prevent injury of important anatomical structures.

A primary research of intensity-modulated dose verification based on anatomic structure of three-dimensional images / 中华放射肿瘤学杂志

Objective To verify IMRT plans in point,planar and 3D dose,and to concretely analyze the dose differences of 3D anatomic structure based on Gamma passing rate.Methods Thimble ion-chamber,Matrixx and ArcCheck were separately used to measure six nasopharyngeal carcinoma treatment plans and six lung cancer treatment plans.The dose measurement deviation of the center point was compared as well as the Gamma passing rate of dose verification under the criteria of both 3％/3 mm and 2％/2 mm,the group t-test and one-way ANOVA were also proceeded.3DVH system was used to analyze the dose measurement deviation of target volume (TV) and organ at risk (OAR) through DVH.Results For IMRT and VMAT treatment plans,the mean deviation of point dose was (0.59 ± 1.31) ％ and (-1.00 ± 1.03)％ respectively,and the maximum deviation was less than 3％.Under the criterion of 3％/3 mm,the Gamma passing rate measured by Matrixx,ArcCheck and 3DVH for IMRT plans was 96.28％,97.55％ and 99.02％ respectively,and for VMAT plans,the corresponding results of three different detectors were 97.24％,99.67％ and 98.48％.The results analyzed and compared by 3DVH showed that even under the condition of high Gamma pass rate (more than 95％ for a Gamma criterion of 3％/3 mm),the DVH metrics of both TV and OAR in two cases (account for 16.7％ of the total plan) were significantly different on the clinical parameters,including GTV,spinal cord and brain stem etc.Conclusions The analysis of dose difference of the measurement results based on Gamma pass rate and on anatomic structure of 3D images can more effectively evaluate the influence of dose error to the implementing of clinical plan and the impact to the clinical treatment.

Diagnostic value of multi-slice spiral CT for lesions in middle and inner ears / 第三军医大学学报

Objective To assess the clinical value of multi-slice CT(MSCT)in showing the ear lesions.Methods MSCT high resolution scan images of 52 ears of 11 normal adult and 15 patients with hearing loss were reconstructed,by bone plus with 0.625 mm collimation,9.6 cm small field of vision(FOV)and 0.3 mm reconstruction interval before volume rendering(VR)and multiplanar reformation(MPR)were performed.Results VR,MIP and MPR images of 40 normal ears clearly showed the complicated anatomic structures.VR,MIP and MPR images of twelve abnormal ears displayed 3 ears of malformations of crus longum incudis,1 ear of destructed semicircular canals,2 ears of malleus dysplasia,2 ears of fusion of incudostapedial joint,2 ears of bony atresia of external auditory complicated with auditory ossicles dysplasia,and 2 ears of crus stapedis dysplasia.MPR is easier to manipulate than VR that has three dimensional effect butis difficult to handle.Conclusion HRCT images,combined with post-processing technique of VR,MIP and MPR,can clearly show the anatomic structures and lesions of middle and inner ears.

Relationship of dynamic changes between protein contents in vegetative organs and growth years of Phytolacca acinosa / 中草药

Objective To provide basis for identification and utilization of Phytolacca decandra. Methods Anatomic structures of different-aged storing roots, stems and leaves of P. decandra were studied by light microscope and histochemical localization. Results Different-aged vegetative organs have active proteins except the young roots, and the protein used to exist in parenchyma cells. ConclusionProtein content in young stems is the highest and the grain size is bigger than the other organs, and the protein content and grain size in young stems have notable differences from that in the old leaves, young leaves, old stems and roots. No protein has been found in two-year-old storing roots and extra cambium.