Objective To evaluate the effect of participation in bone and joint specimen preparation on anatomy exam scores and medical students' feedback to the second anatomy classroom. Methods The students of “4+4” program of clinical medicine enrolled in 2021 were divided into experiment and control groups. The students in experiment group were asked to prepare joint specimens under the guidance of teachers in after class time, while the students in control group only required to observe the specimens. The anatomy exam scores of the two groups were analyzed and and questionnaire survey was implemented to collect students' feedback about the joint specimen preparation. Results There was no significant difference in the scores of final examiniation between the experiment group and the control group. However, the lowest and the highest correct rates in experimenl group (40% and 95% respectively) were both higher than that of the control group (32.5% and 82.5% respectively). If the correct rate of joint specimens was calculated separately, the experiment group (87.0%±16.7%) was significantly higher than that of control group (66.7%±24.3%) (P＜0.01). In the limb theory test, the mean score of the experiment group (84.7%±20.5%) was significantly higher than that of the control group (69.3%±14.5%) (P＜0.05). The students gave a high evaluation to the joint specimen preparation in after class time or called second classroom. Conclusions Medical students' participation in joint specimen preparation as the second classroom can improve their learning outcomes and this second classroom strategy as a supplement to the first classroom may be potentiallt shared by other medical schools.

Objective To explore the effect of mandibular distraction osteogenesis on the masseter muscle in cases of hemifacial microsomia deformity.Methods From February 2010 to March 2015,25 cases of hemifacial microsomia deformity were retrospectively analyzed.Three-dimensional images of masseter muscle and cranial bones were reconstructed through Mimics software,and the volume of the masseter muscle before and after mandibular distraction osteogenesis was measured.Results There was no difference in masseter muscle volume in the uninjured side,pre-and post-surgery (P＞0.05).The volume of the masseter muscle after mandibular distraction osteogenesis was significantly increased compared to pre-operation (P＜0.05).The increased volume of the masseter muscle between type ⅡA and ⅡB hemifacial microsomia deformity patients after mandibular distraction osteogenesis showed no difference (P＞0.05).There was no difference of the increased amount between the mandibular ramus posterior border height and masseter muscle volume (P＞0.05).Conclusion Mandibular distraction osteogenesis may help to increase volume and promote growth of the masseter muscle in children with hemifacial microsonia deformity.It can improve the defect of muscle soft tissue in children with minor hemifacial microsomia

Objective To explore the clinical classification and surgical strategy of Parry-Romberg syndrome based on bone involvement.Methods From 2009 to 2016,a total of 51 patients with Parry-Romberg syndrome were involved in the study.All patients were classified into 3 groups depending on the extent of facial bone involvement.Type Ⅰ consisted of patients without facial bone involvement.The surgical strategy for this group was morphological remodeling of facial soft tissue.Patients with facial bone involvement and without oral and maxillofacial function involvement served as type Ⅱ.For this group,the surgical strategy was morphological remodeling of facial soft tissue and bone tissue.Type Ⅲ consisted of patients with both facial bone and oral and maxillofacial function involvement.In these cases,the surgical strategy was remodeling of oral and maxillofacial function and facial contour.Results All patients were followed-up from 6 to 36 months.Facial symmetry was obviously improved in type Ⅰ and Ⅱ and 5 patients obtained good remodeling of oral and maxillofacial function and bone and soft tissue morphology.Conclusion This clinical classification was helpful to regulate and guide the treatment of Parry-Romberg syndrome.

为了激发学习兴趣、提高教学质量,人体解剖学引入workshop教学模式。根据课程教学计划有系统的阶段性安排workshop教学,每次由1个解剖小组与临床带教老师合作,在标本上完成1个常见的临床模拟手术操作,以加深对局部解剖结构的理解。经过几年时间的探索和试验,workshop教学实践现在已经正式成为人体解剖学教学的一部分,成为一种新的教学模式,受到学生们的普遍欢迎。

Objective To investigate the therapeutic effect of pre-expanded cervico-acromial flap based on the supraclavicular artery for resurfacing soft tissue defects of head and neck. Methods In this series,from Jan 2008 to Jan 2014,24 patients with ages between 5 and 42 years suffering from facial and cervical scar or nevis or port-wine stain were treated.In the first stage,the tissue expander (600ml to 800ml in volume) was implanted on the deep fascia layer of the cervicoacromial region;600 to 800ml saline were injected during a 10 to 16 weeks period.In the second stage after expansion, sufficient skin and tissue was obtained to resurface the defects of head and neck. Results All 24 flaps healed primarily with good functional and cosmetic results.The maximum size of the flap was 23cm × 16cm,whereas the minimum size was 20cm × 8cm.After an average follow-up time of 12 months, significant improvement in function with good esthetic outcomes were achieved,and the donor sites scar seemed acceptable.There were no significant complications. Conclusion The pre-expandedcervico-acromialfasciocutaneous flap based on the supraclavicularartery can provide a large amount of thin tissue with both good color and texture,and without the need for microsurgery, and avoid the disadvantages of donor-site morbidity.This flap is reliable and safe for resurfacing large skindefects of the head and neck.

目的 通过数字化设计和模拟技术分析并探讨半侧颜面短小畸形下颌骨牵张成骨最有效的方向.方法 自2010-2014年,我们对60例半侧颜面短小患者进行下颌骨牵张成骨治疗,对安氏Ⅰ、Ⅱ类咬(牙合)畸形延长的方向分别是垂直于咬(牙合)平面和位于咬(牙合)平面和其垂线之间,通过数字化模拟来确定角度.结果 60例患者中,3例牵引器脱落,5例发生感染,其余患者均顺利完成延长成骨的治疗,患侧下颌骨高度得到良好的恢复;偏斜的咬(牙合)平面获得纠正,咬(牙合)关系恢复很好;颏部偏斜得到很大改善,面部对称性有明显的提高.结论 对于安氏Ⅰ类咬(牙合)最有效的延长方向是与颌平面垂直,对于安氏Ⅱ类咬(牙合)畸形最有效的延长方向是颌平面与其垂直线之间,需要术前数字化模拟来确定准确的角度.

Objective To explore a new method with patients involved computer-aided design in personalized curved osteotemy of prominent mandibular angle,and to evaluate the feasibility of the method.Methods Patients with extraordinary surgical expectation were selected.Then the three dimensional virtual skull models with mandibular cannel were reconstructed for 3D measurement and surgical plan making by both doctors and patients themselves.Followed the surgical plan,the personalized curved osteotemy of mandibular angle was conducted.Then the final outcome and effect of operation was evaluated with computer technology.Results All of the 12 patients' personalized surgical plans were laid down,and the patients had high satisfaction after the operations.And there were significant differences between the parameters values of the skulls measurement before and after the operations(P0.05).Conclusion The application of patients involved computer-aided design in personalized curved osteotemy of prominent mandibular angle has high clinical guidance value and feasibility to help doctor-patients communication,real surgical practice and assessment of operation outcome.

颅颌面外科是通过特殊的截骨和植骨方法将颅颌面骨分块移动,并按照整形美容原则重新组合固定,达到从根本上矫正畸形或美化容貌的新兴学科.骨移植是颅颌面外科中最重要的技术之一.目前,国内外常用于骨移植的供区主要有髂骨、肋骨、颅骨外板等;而关于下颌骨外板的应用最常见于通过将其截除以减小患者下面部的宽度.自体下颌骨外板作为一种骨游离移植供区,早在1970年,SN Kline就应用下颌骨颏部供骨治疗了1例下颌骨骨折延迟愈合的患者,并证实下颌骨外板取材方便、血供充分、并发症少,是良好的骨供区.

Objective To present a new method for correction of prominent malar complex by L-shaped osteotomy and simutaneusly correction of skin loss caused by the former surgery using Temporal Facialplasty. Methods We retrospectively reviewed the treatment process of 48 patients of prominent malar,evaluated the surgical design and results of Combined Surgery of L-type osteotomy with Temporal Facialplasty. Results This method was used in 48 patients with prominent malar complex.47 of the patients obtained good results.Only one patient complained of unsymmetricity,and she was satisfied after revition. Conclusion L-shaped osteotomy for correction of prominent malar complex is a relatively ideal surgical method.Simutaneous Temporal Facialplasty can solve the problems of skin sluggish.