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Background Mitochondria are key regulators in cell proliferation and apoptosis. Alterations in mitochondrial function are closely associated with inflammation and tumorigenesis. This study aimed to investigate whether mitochondrial transcription factor A (TFAM), a key regulator of mitochondrial DNA transcription and replication, is involved in the initiation and progression of colitis‐associated cancer (CAC). Methods TFAM expression was examined in tissue samples of inflammatory bowel diseases (IBD) and CAC by immunohistochemistry. Intestinal epithelial cell (IEC)‐specific TFAM‐knockout mice (TFAM △IEC) and colorectal cancer (CRC) cells with TFAM knockdown or overexpression were used to evaluate the role of TFAM in colitis and the initiation and progression of CAC. The underlying mechanisms of TFAM were also explored by analyzing mitochondrial respiration function and biogenesis. Results The expression of TFAM was downregulated in active IBD and negatively associated with the disease activity. The downregulation of TFAM in IECs was induced by interleukin‐6 in a signal transducer and activator of transcription 3 (STAT3)/miR‐23b‐dependent manner. In addition, TFAM knockout impaired IEC turnover to promote dextran sulfate sodium (DSS)‐induced colitis in mice. Of note, TFAM knockout increased the susceptibility of mice to azoxymethane/DSS‐induced CAC and TFAM overexpression protected mice from intestinal inflammation and colitis‐associated tumorigenesis. By contrast, TFAM expression was upregulated in CAC tissues and contributed to cell growth. Furthermore, it was demonstrated that β‐catenin induced the upregulation of TFAM through c‐Myc in CRC cells. Mechanistically, TFAM promoted the proliferation of both IECs and CRC cells by increasing mitochondrial biogenesis and activity. Conclusions TFAM plays a dual role in the initiation and progression of CAC, providing a novel understanding of CAC pathogenesis., Our study uncover the opposite roles of TFAM in the initiation and progression of CAC, indicating that TFAM switches from tumor suppressor in the premalignant stages of tumorigenesis to oncogene at later stages of disease. Our data suggest that measuring TFAM status may serve as a clinically useful tool to identify patients at risk for colon dysplasia or cancer. In contrast, TFAM might also be a prognostic biomarker and pharmacological target for advanced CAC.

Dowel bars are arranged between two slabs of jointed plain concrete pavements to transfer load between them. The looseness of these dowel bars leads to the decrease of the load transfer efficiency (LTE). Meanwhile, repeated vehicle load can result in void near the joints. In this paper, the behaviors of concrete pavement under the effect of void size and joint stiffness were studied by using ABAQUS software. The FEA model was calibrated for different element parameters based on mesh convergence analysis and validated by comparison with previous studies. The voids beneath slabs were considered in this study, including the loaded slab and unloaded slab. The different effects of base course modulus on the stress of loaded slab are also analysed. It is concluded that the results show that the void size and joint stiffness affect the stress of the loaded plate. Smaller void size and larger joint stiffness will lead to the maximum stress located at the bottom of the loaded slab, and the void size has little effect on the stress of the loaded slab. Otherwise, the larger void size will cause larger stress. The effect of base modulus on stress is similar.

The aim of this study is to compare the clinical outcomes of posteroanterior (PA) lag screws versus posterior buttress plate fixation in treatment of posterior malleolar fragments (PMFs) in spiral tibial shaft fracture, and provide guidance for surgeons selecting a treatment strategy. A total of 48 eligible patients with PMFs associated with spiral tibial shaft fracture surgically treated from March 2009 to January 2016 were included in the study. They were divided into the screw group (n = 24) and the plate group (n = 24). All operations were performed via a posterolateral approach by a senior orthopedic surgeon. The American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analog scale (VAS), and assessment of ankle range of motion (ROM) were used for clinical evaluation. The radiographic evaluation of posttraumatic arthritis scale was determined by Bargon reference criteria. At the mean follow-up period of 29.5 ± 4.3 and 30.4 ± 4.1 months, respectively (p > .05), all patients in both groups had bone union without severe wound problems or complications. There were no significant differences in AOFAS (92.5 ± 5.3 vs 94.7 ± 5.6, p = .129) and VAS (2.4 ± 0.8 vs 2.2 ± 0.9, p = .196) scores between the groups at final follow-up. No significant differences were found between the groups in injured/contralateral ankle ROM or posttraumatic ankle arthritis scale postoperatively (p > .05). For PMFs in spiral tibial shaft fracture, PA lag screws or posterior buttress plate fixation via a posterolateral approach can achieve good and equivalent clinical and radiological outcomes with minimal complications.

Background: Nogo-66 antagonistic peptide (NEP1-40) offers the potential to improve spinal cord injury (SCI). Objective: To explore the effect of NEP1-40 overexpression on neural stem cells (NSCs) regulating the axon regeneration of injured neurons. Methods: We isolated NSCs from brain tissues of pregnant rat fetuses and used Nestin immunofluorescence to identify them. The NEP1-40 overexpressing NSCs were constructed by transfection with the NEP1-40-overexpressing vector. The expression of NSCs differentiation associated markers, including Tuj-1, GFAP, Oligo2, and MBP, were detected by RT-PCR, western blotting, and immunofluorescence. NeuN immunofluorescence staining was used to measure the number of neurons. And western blotting was used to detect the phosphorylation levels of LIMK1/2, cofilin, and MLC-2 and the protein levels of GAP-43, MAP-2, and APP. Results: The NEP1-40 overexpression promoted the expression level of Tuj-1, Oligo2, and MBP, and increased the number of Tuj-1, Oligo2, and MBP positive cells. NEP1-40-overexpressing NSCs (NEP-NSCs) improved NeuN positive cells of co-culture with injured neurons. And NEP-NSCs also increased the protein levels of axon regeneration indicators (GAP-43, MAP-2) and decreased APP protein level. In addition, the phosphorylation level of LIMK1/2, cofilin, and MLC-2 were markedly decreased in NEP-NSCs. Conclusion: NEP1-40 overexpression enhanced the ability of NSCs differentiation into neurons and promoted axon regeneration by inhibiting the Nogo-A/NgR1 signaling pathway. This study provides an alternative gene modified transplantation NSCs for the SCI treatment.

Background After ovarian tissue transplantation, ischemia-reperfusion injury and free radicals cause follicle depletion and apoptosis. Therefore, the use of antioxidants to reduce the production of free radicals is an important method to address the consequences of ischemia-reperfusion injury. Resveratrol is a natural active polyphenol compound with anti-inflammatory, antitumor, strong antioxidant and anti-free radical properties. The aim of this study was to investigate whether resveratrol could improve the effect of autologous ovarian transplantation after cryopreserve-thawn mouse ovarian tissue. Methods Whole-ovary vitrification and autotransplantation models were used to investigate the effects of resveratrol. Six-week-old female mice from the Institute of Cancer Research (ICR) were subjected to vitrification. All ovaries were preserved in liquid nitrogen for 1 week before being thawed. After thawing, ovarian tissues were autotransplanted in the bilateral kidney capsules. Mice (n = 72) were randomly divided into four groups to determine the optimal concentration of resveratrol (experiment I). Treatments were given as follows: saline, 5 mg/kg resveratrol, 15 mg/kg resveratrol and 45 mg/kg resveratrol, which were administered orally for one week. Grafted ovaries were collected for analysis on days 3, 7, and 21 after transplantation. Ovarian follicle morphology was assessed by hematoxylin and eosin staining. Serum FSH and E2 levels were measured to estimate the transplanted ovarian reserve and endocrine function. Other mice were randomly divided into two groups—saline and 45 mg/kg resveratrol to further evaluate the effect of resveratrol and explore the mechanisms underlying this effect (experiment II). Ovarian follicle apoptosis was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assays. Immunohistochemistry, qRT-PCR and western blotting (MDA, SOD, NF-κB, IL-6 and SIRT1) were used to explore the mechanisms of resveratrol. Moreover, oocytes derived from autotransplanted ovaries at 21 days were cultured and fertilized in vitro. Results The proportions of morphologically normal (G1) follicles at 3, 7 and 21 days were significantly higher in the 45 mg/kg resveratrol group than in the saline group. The TUNEL-stained follicles (%) at 7 days were significantly decreased in the 45 mg/kg resveratrol group compared with the saline group. Western blot analysis revealed that SOD2 and SIRT1 levels were significantly higher in the 45 mg/kg resveratrol group than in the saline group at day 7 and that MDA and NF-κB levels were lower in the saline group on day 3. Likewise, IL-6 was lower in the saline group on day 7. These results are basically consistent with the qRT-PCR results. In addition, the mean number of retrieved oocytes and fertilization and cleavage were significantly increased in the 45 mg/kg resveratrol group compared with the saline group. Conclusions Administration of resveratrol could improve the quality of cryopreserved mouse ovarian tissue after transplantation and the embryo outcome, through anti-inflammatory and antioxidative mechanisms.

BackgroundAfter ovarian tissue transplantation, ischemia-reperfusion injury and free radicals cause follicle depletion and apoptosis. Therefore, the use of antioxidants to reduce the production of free radicals is an important method to address the consequences of ischemia-reperfusion injury. Resveratrol is a natural active polyphenol compound with anti-inflammatory, antitumor, strong antioxidant and anti-free radical properties. The aim of this study was to investigate whether resveratrol could improve the effect of autologous ovarian transplantation after cryopreserve-thawn mouse ovarian tissue.MethodsWhole-ovary vitrification and autotransplantation models were used to investigate the effects of resveratrol. Six-week-old female mice from the Institute of Cancer Research (ICR) were subjected to vitrification. All ovaries were preserved in liquid nitrogen for 1 week before being thawed. After thawing, ovarian tissues were autotransplanted in the bilateral kidney capsules. Mice (n=72) were randomly divided into four groups to determine the optimal concentration of resveratrol (experiment I). Treatments were given as follows: saline, 5 mg/kg resveratrol, 15 mg/kg resveratrol and 45 mg/kg resveratrol, which were administered orally for one week. Grafted ovaries were collected for analysis on days 3, 7, and 21 after transplantation. Ovarian follicle morphology was assessed by hematoxylin and eosin staining. Serum FSH and E2 levels were measured to estimate the transplanted ovarian reserve and endocrine function. Other mice were randomly divided into two groups—saline and 45 mg/kg resveratrol to further evaluate the effect of resveratrol and explore the mechanisms underlying this effect (experiment II). Ovarian follicle apoptosis was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assays. Immunohistochemistry, qRT-PCR and western blotting (MDA, SOD, NF-κB, IL-6 and SIRT1) were used to explore the mechanisms of resveratrol. Moreover, oocytes derived from autotransplanted ovaries at 21 days were cultured and fertilized in vitro. ResultsThe proportions of morphologically normal (G1) follicles at 3, 7 and 21 days were significantly higher in the 45 mg/kg resveratrol group than in the saline group. The TUNEL-stained follicles (%) at 7 days were significantly decreased in the 45 mg/kg resveratrol group compared with the saline group. Western blot analysis revealed that SOD2 and SIRT1 levels were significantly higher in the 45mg/kg resveratrol group than in the saline group at day 7 and that MDA and NF-κB levels were lower in the saline group on day 3. Likewise, IL-6 was lower in the saline group on day 7. These results are basically consistent with the qRT-PCR results. In addition, the mean number of retrieved oocytes and fertilization and cleavage were significantly increased in the 45 mg/kg resveratrol group compared with the saline group. ConclusionsAdministration of resveratrol could improve the quality of cryopreserved mouse ovarian tissue after transplantation and the embryo outcome, through anti-inflammatory and antioxidative mechanisms.

Background The diagnosis, treatment, and efficacy evaluation of anterior cruciate ligament (ACL) partial rupture remains controversial. This research aims to investigate the underlying mechanism of partial ACL injuries to the meniscus degeneration in the rabbit knee. Methods Sixty New Zealand white rabbits were randomly divided into three groups including an experimental group, a sham group (n = 6), and a blank control group (n = 6). The experimental group is composed of an anteromedial bundle (AMB) rupture group (n = 24) and a posterolateral bundle (PLB) rupture group (n = 24). Rabbits in the experimental group were subjected to right hind limbs knee surgery to induce ACL part injury under the arthroscopy. Finally, eight rabbits including 6 in the model group and 2 in the control group were sampled randomly on the 2nd, 4th, and 8th weeks respectively. We observed the typical form of the meniscus through HE staining. Expressions of inflammatory factors including interleukin-1β (IL-1β) and IL-17 in the knee joint fluid were determined by means of an ELISA. Analysis of the mRNA expressions of matrix metalloproteinases-13(MMP-13) was performed to evaluate the inflammatory mediators in the pathogenesis of the meniscus. Results HE staining results showed that the surface was rough and the tissues were loose displaying collagen fibers of varying thickness. Both IL-1β and IL-17 in the synovial fluid and the positive rate of MMP-13 in addition to MMP-13 mRNA showed a demonstrable increase treads from the 2nd to the 8th week. The significant difference was found (P < 0.05) compared to the control group. Conclusion We conclude that the elevated levels of IL-1β and IL-17, along with increased MMP13 expression, resulted in meniscus degradation in the rabbit knee joint model with partial ACL injury.

Background Percutaneous kyphoplasty (PKP) is widely applied for the treatment of osteoporotic vertebral compression fractures (OVCFs) and has achieved satisfactory clinical results. With the accumulation of clinical cases and prolonged follow-up times, the inability to reconstruct vertebral height defects has attracted more and more attention. A comparison of clinical effects was retrospectively reviewed in 72 patients who underwent simple PKP or pedicle in vitro restorer (PIVR) combined with PKP to discuss the clinical application of self-developed PIVR used in PKP. Methods From August 2013 to August 2016, 72 patients with OVCFs were treated surgically, with 30 patients undergoing PKP (group A) and 42 undergoing PIVR combined with PKP (group B). Operation-related situations, radiological data, and related scores were compared between the two groups by corresponding statistical methods. Results Bone cement was successfully injected into 72 vertebral bodies. Sixty-three cases were followed up for an average of 14 months. There were significant differences between the two groups in the improvement of the height of the vertebral body, sagittal Cobb angle, and visual analogue scale (VAS) 1 week after the operation (P 0.05). Conclusion PIVR combined with PKP can overcome the limitations of PKP alone, that is, hardly restoring vertebral height and height being easily lost again with balloon removal. The combined method can also restore the vertebral fractures to a satisfactory height and effectively maintain the stability of the spine, which improves the long-term quality of life of patients. Thus, PIVR combined with PKP is a better choice for patients with OVCFs.

To investigate the relationship between the facet fluid sign (FFS) and kinematics of affected lumbar segment in patients with low-grade, single-level lumbar degenerative spondylolisthesis using kinematic magnetic resonance imaging (kMRI).Materials and methods Ninety-two patients diagnosed with low-grade (Grade 1 or 2), single level lumbar degenerative spondylolisthesis L3 to S1. Angular and translational motion, whole lumbar motion, slip percentage, and facet angle were measured. Disc degeneration and degrees of osteoarthritis were graded, facet effusion was evaluated and classified as Positive or Negative FFS (PosFFS or NegFFS).Results There were significant differences in the facet degeneration, translational motion, percentage of total angular motion, and flexion-extension slip difference between the PosFFS and NegFFS group. 28.3% of the patients in PosFFS group had anterolisthesis in flexion, but not extension.There was a significant difference in the incidence of FFS between the dynamic and static spondylolisthesis (75% vs 35%, p 0.001). If FFS was present on kMRI, a positive predictive value for dynamic spondylolisthesis was 75.6%. with the sensitivity and specificity of 0.75 and 0.65 for posFFS to diagnose dynamic DS. The likelihood ratio for dynamic slips in the presence of FFS was 2.1, and the likelihood ratio for static slips in the presence of FFS was 1.1.Conclusion Facet fluid sign was present in weight-bearing neutral position, and the presence of FFS in kMRI increased the probability of having dynamic spondylolisthesis.

Periodontal ligament stem cells (PDLSCs) have been confirmed to have self-renewal capacity and multidifferentiation potential and are good candidates for periodontal tissue regeneration. Pulsed electromagnetic field (PEMF) has been demonstrated to promote osteogenesis in non-union fractures, partly by regulating mesenchymal stem cells or osteoblast activity. However, there is no report about the osteo-inductive effect of PEMF stimulation on human PDLSCs (hPDLSCs). Thus, we tested the hypothesis that PEMF biophysical stimulation alone has an influence on the proliferation and osteogenic differentiation of hPDLSCs. To detect the osteo-inductive potential of bone morphogenetic protein (BMP9), we transfected the STRO-1(+) /CD146(+) hPDLCSs with BMP9-expressing recombinant adenoviruses. We examined the proliferation and osteogenic differentiation of hPDLSCs treated with either PEMF (15 Hz, 1 h daily, different intensities), or BMP9, or both stimuli. Cell counting kit-8 (CCK-8) assay showed that PEMF of different intensities had no effect on the proliferation of hPDLSCs and did not enhance the proliferative capability of BMP9-transfected cells. Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting showed that the combination of both PEMFs (1.8 or 2.4 mT) and BMP9 stimulation had a synergistic effect on early and intermediate osteogenic genes and protein expressions of runt-related transcription factor 2, alkaline phosphatase, osteopontin, and late mineralized extracellular matrix formation in hPDLSCs. Bioelectromagnetics. 38:63-77, 2017. © 2016 Wiley Periodicals, Inc.

The main inorganic minerals in natural bones are non-stoichiometric hydroxyapatite (HA, Ca10[PO4]6[OH]2) doped with various trace elements, which may possess important biochemical effects. To investigate the functions of Sr and Si elements in human hard tissues, non-doped HA, trace Si doped HA, Si and Sr codoped HA with the concentration of natural bones are synthesized by hydrothermal method in this study. The samples are characterized by powder X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscope (SEM). The biological activities are evaluated via cytotoxicity study, adhesion and proliferation of osteoblast measurement, and alkaline phosphatase (ALP) assay. All the synthesized materials are HA phase, which have hierarchical structures with oriented HA nanorods assembled into the platy particles. These materials are non-cytotoxic against L929 cells line even at 400 μg/ml powder suspension. The results clearly indicate that the proliferation of L929 cells increases with trace elements doping from trace Si-HA to Si + Sr-HA. The adhesion and proliferation of osteoblast measurement illustrates that proliferation of osteoblasts advances about 1.3 times for Si-HA and about 1.8 times for Si + Sr-HA compared with undoped HA. In general, Si-HA with trace Si element shows enhanced cell differentiation, and Si + Sr-HA dual-doped with Si and Sr elements presents increased biological activity compared with Si-HA.

Purpose: The decoction of collagen extracted from Carapacis et Plastri Testudinis (CCPT) has been reported to have an effect of anti-osteoporosis. The present study was to investigate the in vitro molecular mechanisms effect of CCPT on ROS1728 differentiation and proliferation. Methods: Rat osteoblast cell line (ROS 1728) was cultured and exposed to CCPT at different concentrations. The effect of CCPT on the proliferation of ROS1728 was evaluated through detecting the activity of Alkaline Phosphatase (ALP) and the type I collagen (Coll-I) content. The gene expression of ALP, Coll-I, Osteocalcin (OC), Runx2, Osterix (Osx), Osteoprotegerin (OPG) and RANKL (receptor activator of NF-MB ligand) was observed using RT-PCR analysis. Results: The results showed that CCPT treatment (2.5, 5.0 and 10.0 mg/ml) affected the proliferation of ROS1728 in a concentration-dependent manner. The highest expression was obtained by treatment with 5 mg/ml of CCPT after a nine-day treatment duration based on ALP activity and Coll-I content (P

Semi-flexible composite mixture (SFCM) is developed based on a unique material design concept of pouring cement mortar into the voids formed by open graded asphalt mixture. It combines the flexibility of asphalt concrete and the stiffness of Portland cement concrete and has many advantages comparing to conventional roadway paving materials. The main objective of this paper was to evaluate the engineering properties of SFCM and assess the constructability of the SFCM. A slab SFCM sample was fabricated in the laboratory to simulate the filling of cement mortar in the field. Performance testing was carried out by indirect tensile (IDT) test because it was found to be able to correlate with the field performance of asphalt mixtures at low, intermediate, and high temperatures. They were used in this study to evaluate the thermal cracking, fatigue, rutting, as well as moisture resistance of SFCM. A control hot mix asphalt (HMA) mixture was used to compare with the results of SFCM. Based on the testing results, it was found that the designed SFCM showed good filling capability of cement mortar. SFCM had higher dynamic modulus than the control HMA. It had good resistance to rutting and moisture damage. Based on fracture work, SFCM showed better resistance to thermal cracking while lower resistance to fatigue cracking.

Previous studies have shown that neurofilament protein M expression is upregulated in the early stage of spinal cord ischemia/reperfusion injury, indicating that this protein may play a role in the injury process. In the present study, we compared protein expression in spinal cord tissue of rabbits after 25 minutes of ischemia followed by 0, 12, 24, or 48 hours of reperfusion with that of sham operated rabbits, using proteomic two-dimensional gel electrophoresis and mass spectrometry. In addition, the nerve repair-related neurofilament protein M with the unregulated expression was detected with immunohistochemistry and western blot analysis. Two-dimensional gel electrophoresis and mass spectrometry showed that, compared with the sham group, upregulation of protein expression was most significant in the spinal cords of rabbits that had undergone ischemia and 24 hours of reperfusion. Immunohistochemical analysis revealed that neurofilament protein M was located in the membrane and cytoplasm of neuronal soma and axons at each time point after injury. Western blot analysis showed that neurofilament protein M expression increased with reperfusion time until it peaked at 24 hours and returned to baseline level after 48 hours. Furthermore, neurofilament protein M is phosphorylated under oxidative stress, and expression changes were parallel for the phosphorylated and non-phosphorylated forms. Neurofilament protein M plays an important role in spinal cord ischemia/reperfusion injury, and its functions are achieved through oxidative phosphorylation.

To investigate the changes of lumbar neural foramina size during dynamic motion using positional MRI. Two hundred and fifty neural foramina from 50 patients were analyzed. Lumbar foraminal height, width, and area parameters from L1 to S1 were evaluated for changes in extension, neutral, and flexion positions on T2 parasagittal positional MRI images, and were correlated to lumbar angular motion. One-way analysis of variance (ANOVA) and post hoc analysis were used to examine the differences between levels and positions. Compared to the neutral position, almost all lumbar foraminal parameters (height, width at inferior level, and area) increased in flexion and decreased in extension at all levels, except for L5–S1 foraminal width at superior and middle levels. The foraminal height and area in all lumbar segments except L5–S1 increased as the lumbar angular motion changed from extension to flexion in

The aim of this study was to investigate the prevalence and characteristics of imipenem-resistant Acinetobacter baumanni isolated from surgical wards in a university hospital, China. A total of 143 non-duplicate A. baumannii were isolated from 517 inpatients in surgery intensive care units (ICUs), burn wards, and general surgery wards. Of these, 102 isolates of A. baumannii (71.3%) were resistant to imipenem. Among imipenem-resistant isolates, all isolates were resistant to almost all antimicrobial agents except polymyxin E, all isolates were positive for blaOXA-23 and blaOXA-51 in addition to ISAba1, 52 (51%) were positive for blaOXA-58, 8 (7.8%) contained blaVIM-2, which co-harbored with blaOXA-58. Molecular typing revealed the presence of three clones among imipenem-resistant isolates. This study confirmed that A. baumannii strains harboring OXA or VIM type β-lactamases are widely distributed throughout the surgery wards. The data demonstrate that there was a high prevalence of imipenem-resistant A. baumannii infection in the region.

Background There is growing evidence that periodontal treatment may affect glycemic control in diabetic patients. And several systematic reviews have been conducted to assess the effect of periodontal treatment on diabetes outcomes. Researches of this aspect are widely concerned, and several new controlled trials have been published. The aim of this study was to update the account for recent findings. Methods A literature search (until the end of January 2014) was carried out using various databases with language restriction to English. A randomized controlled trial (RCT) was selected if it investigated periodontal therapy for diabetic subjects compared with a control group received no periodontal treatment for at least 3 months of the follow-up period. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were periodontal parameters included probing pocket depth (PPD) and clinical attachment level (CAL). Results Ten trials of 1135 patients were included in the analysis. After the follow-up of 3 months, treatment substantially lowered HbA1c compared with no treatment after periodontal therapy (–0.36%, 95%CI, −0.52% to −0.19%, P

Medical education models play an important role in medical education, especially in military medical education. However, there are shortcomings in various existing teaching models of maxillofacial gunshot injuries. To resolve this issue, we integrated a dynamic simulation of image data to create a new, three-dimensional dynamic digital teaching model that was based on our previous completed three-dimensional finite element model of human maxillofacial bone tissue gunshot injuries. This model was applied to teaching practice with good results. The new model has helped us to achieve the teaching objective and improve the teaching efficiency.

Free radial forearm flaps have many advantages and thus remain the dominant multi-purpose flap used in the reconstruction of maxillofacial soft tissue defects. This report summarizes our experience over 20 years of applying free radial forearm flaps and illustrates four stages of technical improvement regarding the selection of the anastomotic veins at the donor site and at the recipient site in addition to the choice of the method to be used for flap harvest. We believe that the key to improving the transplantation success rate for free radial forearm flaps is based on the following factors. First, the branches of the internal jugular vein are the preferred targets for anastomosis at the recipient site. Second, during flap harvest, it is necessary to retain the external fascia between the arteries and veins. Third, it is necessary to select veins in two vascular systems of different depths for concurrent anastomosis.