Objective To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of cl inical therapy. Methods The cl inical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) withnon-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbl ing in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospital ization; and 5 cases were identified as unilateral condylar fractures (3 compl icated by mental fractures) and 3 cases as bilateral condylar fractures compl icated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by fall ing from height in 4 cases, by tumbl ing in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospital ization; and 12 cases were identified as unilateral condylar fractures (3 compl icated by mental fractures) and 5 cases as bilateral condylar fractures (1 compl icated by mental fracture). Results Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or l imited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P gt; 0.05). During centric occlusion, mental point located at the midl ine with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had sl ight snap when opening their mouths. Mandible deviation was observed in 3 patients of 2 groups, respectively when gaping. The X-ray films showed heal ing of fracture and condylar remodel ing at 3-6 months. Mandibular ramus were symmetric in cephalometry. Conclusion Good effectiveness can be obtained by surgical or non-surgical treatment in pediatric mandibular condylar fractures. Considering the pediatric mandibular condyle having powerful heal ing and reconstructing potency and avoiding secondary injury on the temporomandibular joint from surgery, non-surgical treatment should be first selected for the pediatric mandibular condylar fractrues in patients under 7 years.
Paclitaxel (PTX)-loaded self-assembling nano-micelles (PTX/NMs) were prepared based on amphiphilic cholesterol-bearing γ-polyglutamic acid (γ-PGA-graft-CH). The properties of PTX/NMs in vitro and in vivo were investigated. The results indicated that PTX could be entrapped in γ-PGA-graft-CH NMs. PTX/NMs was characterized with a size of (343.5 ± 7.3) nm, drug loading content of 26.9% ± 0.8% and entrapment efficiency of 88.6% ± 1.7% at the optimized drug/carrier ratio of 1/10, and showed a pH-sensitive sustainable drug-release and less cytotoxicity in vitro. In vivo release and the pharmacokinetics study in mice showed that the elimination half-life (t1/2β) and area under curve (AUC) of PTX/NMs were significantly higher than those of PTX/polyoxyethylene castor oil (PTX/PCO), and less clearance (CL) of PTX/NMs was also observed. PTX/NMs were distributed higher in liver and tumor than PTX/PCO, and showed a good tumor-inhibiting activity in tumor-bearing mice. This study would lay a foundation on the potential application of γ-PGA-graft-CH NMs were the antitumor drug-delivery.
Objective To explore adaptive condition of preparation of animal model and afford reliable and stable model animal for further research on clinical diagnosis and treatment of cavernous transformation of portal vein (CTPV) by establishment of animal model by partial portal vein stenosis. Methods According to different straight blunttip needles used, 80 healthy Sprague-Dawley rats were randomly averagely divided into 4 groups: sham operation group, gauge 19 (19G) group, gauge 21 (21G) group and gauge 23 (23G) group. Six weeks after model making, pressure measurement and angiography of portal vein and pathological examination of portal vein and its surrounding tissues were used to evaluate portal hypertension and CTPV. Results Six weeks after model making no rat died in sham operation group, while the numbers of died rats in 19G group, 21G group and 23G group were 2, 4 and 16, respectively. No portal hypertension was displayed in sham operation group and 19G group 6 weeks after model making. Portography showed that the portal vein seemed smooth without variceal and dilatation in sham operation group and 19G group. Pathological examination demonstrated that the portal vein walls were not enlarged, endothelial cells were smooth. The smooth muscles of middle membrane were not thickened and adventitia was intact. Portal pressure increased and CTPV formed in 21G group and 23G group 6 weeks after model making. Portography showed that collateral circulation formed around portal vein in 21G group and 23G group. The vessel lumens with different size and irregular shapes were displayed by pathological examination. Within the narrow fibrous septum between there were the lumens the fat cells, scattered lymphocytes and mast cells, etc. The portal vein walls were enlarged notably, endothelial cells were damaged, the smooth muscle of middle membrane were thickened, thrombosis were formed. Conclusion Establishment of CTPV animal models by partial portal vein stenosis is a reliable method. 21G blund-tip needles fits well in the preparation of CTPV, which is reliable and stable with lower mortality.
Objective To summarize the diagnosis and endovascular treatment of middle cerebral artery (MCA) bifurcation aneurysm. Methods Between January 2010 and June 2011, 32 patients with MCA bifurcation aneurysm underwent endovascular treatment. There were 12 males and 20 females, aged 49.5 years on average (range, 35-81 years). All patients had sudden headache, 2 cases had disturbance of consciousness and hemi plegia, and 22 cases had a history ofhypertension. Before operation, 10 cases were classified as Hunt-Hess level I, 15 cases as level II, and 7 cases as level III; 24 cases were classified as Fisher level II and 8 cases as level III. The patients underwent coil embolization using single microcatheter in 16 cases, using double microcatheter in 7 cases, using balloon-assisted in 4 cases, using single stent in 4 cases, and using double stent in 1 case. Results The results of postoperative immediate digital subtraction angiography showed that 30 patients achieved dense embolization, and 2 patients using single microcatheter achieved approximated dense embolization. Among them, 18 cases suffered extensive subarachnoid hemorrhage, thus lumbar puncture continued drainage was performed for 3-7 days; the other 14 cases had l ittle subarachnoid hemorrhage, lumbar puncture released hemorrhagic cerebrospinal fluid discontinuously, and after1 week, head CT demonstrated that subarachnoid hemorrhage was significantly decreased. At 1 day after surgery, 2 patients had local cerebral ischemia; after Nimotop and other drugs were used for 1 week, the symptom was alleviative. All 32 patients were followed up 4 to 17 months. No aneurysm rupture and bleed occurred during follow-up; no other complications or sequelae was observed except for 3 cases of hemiparesis and 1 case of aphasia. The computed tomographic angiography examination showed no re-open of dense embolized aneurysm at 3, 6 months, and 1 year after surgery. Conclusion As long as appropriate intervention treatment method is chosen, endovascular treatment of MCA bifurcation aneurysm is safe and effective.
【Abstract】 Objective To develop a novel cartilage acellular matrix (CACM) scaffold and to investigate its performance for cartilage tissue engineering. Methods Human cartilage microfilaments about 100 nm-5 μm were prepared after pulverization and gradient centrifugation and made into 3% suspension after acellularization treatment. After placing the suspension into moulds, 3-D porous CACM scaffolds were fabricated using a simple freeze-drying method. The scaffolds were cross-l inked by exposure to ultraviolet radiation and immersion in a carbodiimide solution 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride and N-hydroxysucinimide. The scaffolds were investigated by histological staining, SEM observation and porosity measurement, water absorption rate analysis. MTT test was also done to assess cytotoxicity of the scaffolds. After induced by conditioned medium including TGF-β1, canine BMSCs were seeded into the scaffold. Cell prol iferation and differentiation were analyzed using inverted microscope and SEM. Results The histological staining showed that there are no chondrocytefragments in the scaffolds and that toluidine blue, safranin O and anti-collagen II immunohistochemistry staining werepositive. The novel 3-D porous CACM scaffold had good pore interconnectivity with pore diameter (155 ± 34) μm, 91.3% ± 2.0% porosity and 2 451% ± 155% water absorption rate. The intrinsic cytotoxicity assessment of novel scaffolds using MTT test showed that the scaffolds had no cytotoxic effect on BMSCs. Inverted microscope showed that most of the cells attached to the scaffold. SEM micrographs indicated that cells covered the scaffolds uniformly and majority of the cells showed the round or ell iptic morphology with much matrix secretion. Conclusion The 3-D porous CACM scaffold reserved most of extracellular matrix after thoroughly decellularization, has good pore diameter and porosity, non-toxicity and good biocompatibil ity, which make it a suitable candidate as an alternative cell-carrier for cartilage tissue engineering.