BACKGROUND & AIMS: :Surgeons who communicate on a regular basis with an anaplastologist will benefit from having a more comprehensive practice and will be able to provide a broader depth of information to their patients contemplating facial reconstruction. When a prosthesis is chosen as the best option, it is important for the surgeon to understand that early communication with the anaplastologist can lead to improved appearance and function of the prosthesis. When the surgeon and anaplastologist work closely, their efforts complement one another in creating a final reconstructive plan that will ultimately improve the patient's quality of life.

背景与目标： : 定期与外科医生进行交流的外科医生将受益于更全面的实践，并能够为考虑面部重建的患者提供更广泛的信息。当选择假体作为最佳选择时，对于外科医生来说，重要的是要了解与外科医师的早期沟通可以改善假体的外观和功能。当外科医生和外科医生密切合作时，他们的努力相互补充，以创建最终的重建计划，最终将改善患者的生活质量。

BACKGROUND & AIMS: :Eleven patients with roller injuries to the upper extremity are described. Nine were treated initially; two were referred for treatment within 3 weeks after injury. Six patients were injured by kneading machines in bakeries, two by hot dry-cleaning mangles, two by industrial rolling machines, and one by a transmission belt which acted as a roller. The tissue damage depends on (1) the space between the rollers, (2) the speed of the rollers, (3) the hardness of the rollers, (4) the temperature of the rollers, and (5) how violently the patient attempts to withdraw the entrapped part. Lesions may be closed, consisting of a compression of the soft tissues, which may result in skin necrosis, or a tearing and separation of the skin and soft tissues away from the deep fascia (more common on the dorsal surface of the hand), or destruction of skin and deep tissue because of burns. Closed injuries usually respond to conservative care, although decompression sometimes is necessary. Experience gained from treating these 11 patients indicates that the inexperienced surgeon often tries to replace distally based flaps. Such flaps usually die and predispose to deep infection. If the condition of the wound permits, primary skin grafts should be applied; but if the bed is of poor quality, skin grafting can be delayed for several days. If it is necessary to protect exposed deep structures, they should be covered with immediate pedicle flaps. It is better to use skin from an uninjured area for a free skin graft than to use the avulsed skin as a graft. Distant flaps should be used if secondary reconstruction is anticipated. In circumferential skin loss, a combination of pedicle skin and free skin grafts is better than encircling the part with a pedicle flap. The thumb and radial fingers should be preserved, but the ulnar fingers are expendible in severe injuries. By amputating parts of fingers, reconstruction often is simplified.

背景与目标： : 描述了11例上肢滚子受伤的患者。最初治疗了9个; 受伤后3周内转诊了2个。六名患者在面包店被捏合机伤害，两名被热干洗杂物伤害，两名被工业轧制机伤害，一名被用作滚筒的传动带伤害。组织损伤取决于 (1) 辊之间的空间，(2) 辊的速度，(3) 辊的硬度，(4) 辊的温度，以及 (5) 患者尝试如何剧烈地抽出夹带的部分。病变可能是闭合的，包括软组织的压迫，这可能导致皮肤坏死，或皮肤和软组织远离深筋膜撕裂和分离 (更常见于手背表面)，或由于烧伤而破坏皮肤和深层组织。闭合性损伤通常对保守护理有反应，尽管有时减压是必要的。从治疗这11名患者中获得的经验表明，经验不足的外科医生经常尝试更换远端皮瓣。这种皮瓣通常会死亡并容易感染。如果伤口条件允许，应进行初次皮肤移植; 但是如果床质量差，则植皮可以延迟几天。如果有必要保护裸露的深层结构，则应立即用椎弓根皮瓣覆盖。使用未受伤区域的皮肤进行游离皮肤移植比使用撕脱的皮肤作为移植更好。如果预计二次重建，应使用远处皮瓣。在周向皮肤丢失中，椎弓根皮肤和游离皮肤移植物的组合比用椎弓根皮瓣包围该部分更好。应保留拇指和radial骨手指，但在严重受伤时尺骨手指可扩展。通过截肢手指的一部分，重建通常被简化。

BACKGROUND & AIMS: OBJECTIVE:to prevent kidney injury in renal artery and juxta-renal aortic surgery. After 30 min of cross-clamping ischaemia, renal arterial inflow is temporary re-established for 3 min. The aim of the study was to retrospectively analyse the results of this original technique. METHODS:between January 1987 and May 1999, 48 patients underwent kidney short-term arterial blood reperfusion, directly or through the Pruitt-Inahara shunt. The reperfusion was repeated every 30 min of ischaemia, whenever necessary. Fifty control patients underwent <30 min of kidney ischaemia. Patients were assessed by serum creatinine, digital angiography and radioisotope renography using technecium(99). RESULTS:in the study group one patient developed an acute renal failure and died (2% (-95% CI: 0-11%)). In both study and control groups patients showed a similar and moderate but temporary decline in renal function, which returned to preoperative levels after 1 week. CONCLUSIONS:the results of this study indicate that kidney short-term reperfusion may protect renal tissue from prolonged cross-clamping ischaemia (up to 100 min), also in patients considered at high risk for acute renal failure.

背景与目标：

BACKGROUND & AIMS: :Using several cases that demonstrate partial or total reconstruction of the nose, the author discusses the necessity of not only a complete functional but an aesthetically acceptable end result of the surgery. Sophisticated surgical refinements of the complex anatomic structures of the nasal tip alae and columella are strongly emphasized, with a first-time description of a newly devised forehead compound island flap for nasal reconstruction.

背景与目标： : 通过几种证明鼻子部分或全部重建的病例，作者讨论了不仅手术具有完整功能而且在美学上可接受的最终结果的必要性。强烈强调对鼻尖alae和小柱的复杂解剖结构进行复杂的外科手术改进，并首次描述了新设计的用于鼻重建的前额复合岛状皮瓣。

BACKGROUND & AIMS: BACKGROUND:Unicuspid anatomy of the aortic valve is infrequent but may require intervention by age 40 for severe regurgitation. We propose a new repair technique for the regurgitant unicuspid valve by converting it into a bicuspid aortic valve. METHODS:Between November 2003 and September 2007, 20 patients underwent regurgitant unicuspid aortic valve repair: 13 had aortic regurgitation (AR) and 7 had combined regurgitation and stenosis. Four patients had previously undergone balloon valvuloplasty for critical aortic stenosis. The aim of the repair was to construct a bicuspid valve with two normal commissures and unrestricted cusp motion. The fused cusp tissue was divided anteriorly and a new commissure of normal height was created. Noncoronary and right coronary cusps were extended with autologous pericardium. Concomitant operations included ascending aortic replacement in 7 and resection of subaortic stenosis in 1. RESULTS:No early or late deaths occurred. Intraoperative echocardiography revealed minimal or no AR in 19 patients. Follow-up was 4 to 47 months. One patient underwent valve re-repair for recurrent and progressive aortic regurgitation 3 years postoperatively. All other valves remained stable throughout the follow-up period. Freedom from relevant aortic insufficiency (> or = II) at 4 years was 77%; freedom from reoperation was 67%; and freedom from valve replacement was 100%. CONCLUSIONS:The regurgitant unicuspid aortic valve can be repaired successfully and reproducibly by converting it into bicuspid anatomy. The functional results are comparable with those obtained in reconstructed bicuspid aortic valves. With this approach, replacement can be avoided in most patients with regurgitant unicuspid aortic valves.

背景与目标：

BACKGROUND & AIMS: :The implementation of laser surface scanning to assess facial symmetry after unilateral face-lift procedures used to reconstruct defects after skin tumor resection is presented. Six patients who had undergone defect reconstruction with a flap raised from the subcutaneous plane were included in the study. Immediate postoperative photographic evaluation confirmed facial asymmetry because of unilateral skin tension. After a minimum follow-up period of 1 year, photographic and laser surface scanning analysis showed restored facial symmetry. In conclusion, laser surface scanning is a promising technology for objectifying results obtained and could be implemented for evaluation of the immediate and long-term effects from rhytidectomy procedures. Subcutaneous flaps without duplication or resection of the superficial musculoaponeurotic system are ideal for unilateral procedures because facial symmetry is restored after 1 year.

背景与目标： : 提出了在皮肤肿瘤切除术后用于重建缺损的单侧面部整容程序后，激光表面扫描的实施来评估面部对称性。该研究包括六名从皮下平面抬起皮瓣进行缺损重建的患者。术后立即进行照相评估，证实由于单侧皮肤张力而导致面部不对称。经过1年的最小随访期后，照相和激光表面扫描分析显示恢复了面部对称性。总之，激光表面扫描是一种有前途的技术，可用于客观化获得的结果，并且可以用于评估除皱术的近期和长期效果。没有重复或切除浅表肌腱膜系统的皮下皮瓣是单侧手术的理想选择，因为面部对称性在1年后恢复。

BACKGROUND & AIMS: BACKGROUND AND PURPOSE:Patients with fusiform basilar trunk aneurysms have a poor prognosis. Reconstructive endovascular therapy is possible with modern devices. We describe the clinical presentation, radiologic features, and clinical outcome of 13 patients with fusiform basilar trunk aneurysms treated with flow diverters, stents, and coils. MATERIALS AND METHODS:Of the 13 patients, 7 were men and 6 were women with a mean age of 59.7 years. Clinical presentation was SAH in 3 patients, mass effect on the brain stem in 4 patients, vertebral artery dissection in 1 patient, and the aneurysm was an incidental finding in 5 patients. Mean aneurysm size was 21 mm. All except 1 were large or giant aneurysms. Nine aneurysms were partially thrombosed. RESULTS:Stents were used in all 13 patients, in 2 patients with additional flow diverters and in 11 patients with additional coils. In 4 patients, 1 vertebral artery was subsequently occluded with coils to decrease flow into the aneurysm. Of 13 patients, 9 had a good outcome with adequate aneurysm occlusion and stable size on follow-up of 6-72 months. One of 3 patients who presented with SAH died of a rebleed 1 month later. One other patient died soon after treatment of in-stent thrombosis, and another patient became mute after treatment. In 2 of 3 patients who presented with symptoms of mass effect, there was improvement at a follow-up of 6-24 months. CONCLUSIONS:Reconstructive endovascular therapy of fusiform and dissecting basilar trunk aneurysms is feasible but carries substantial risks. The safety and effectiveness in relation to natural history has not yet been elucidated.

背景与目标：

BACKGROUND & AIMS: :There is considerable variation in the post-operative management of head and neck free flaps in the UK. We undertook a national postal survey of maxillofacial surgical units in the UK who perform free flap reconstruction following ablative head and neck surgery. Questions were asked about the routine postoperative care of a hypothetical, straightforward patient undergoing free flap reconstruction to determine whether there were any trends in managing these patients. There was considerable variation in the number of free flaps performed by each unit per year. The majority of patients (87%) are managed in either an intensive care or high dependency unit. The routine use of a tracheostomy is common (69%). There was also variation in the management of these cases, particularly with the requirement for ventilation. Few units routinely use dextran or dobutamine infusions, although one-to-one nursing and invasive cardiovascular monitoring are commonplace. Alternative provision of postoperative care is discussed.

背景与目标： : 在英国，头颈部游离皮瓣的术后管理存在很大差异。我们对英国的颌面外科部门进行了全国邮政调查，这些部门在进行了头颈部消融手术后进行了游离皮瓣重建。询问了有关进行游离皮瓣重建的假设，直接的患者的常规术后护理的问题，以确定管理这些患者是否有任何趋势。每年每个单位执行的自由襟翼数量差异很大。大多数患者 (87%) 在重症监护或高依赖性病房中进行管理。气管切开术的常规使用是常见的 (69%)。这些病例的管理也有所不同，特别是在通风要求方面。尽管一对一的护理和侵入性心血管监测很普遍，但很少有单位常规使用右旋糖酐或多巴酚丁胺输注。讨论了术后护理的替代提供。

BACKGROUND & AIMS: AIM:This paper presents a literature review conducted to establish what was already known about critical reflection in the nursing literature and what work had been done on using a critical social theory framework as the basis for critical reflection. BACKGROUND:Critical thinking emerged as a significant aspect of nursing education and practice in the late 1980s. It has been promoted as a means by which issues in clinical practice can be examined through a systematic process of exploration and reasoning. Traditionally, critical thinking has commonly involved an attempt to link practice with theory using a scenario or exemplar from practice to illustrate a practice dilemma. This process is often constructed as a retrospective narrative of events. This paper provides a deconstructive-reconstructive approach that differs from some traditional approaches by taking a critical social theory perspective with an emphasis on improving practice. METHODS:The nursing literature reviewed was accessed through Cumulative Index of Nursing and Allied Health Literature (CINAHL). The search was restricted to English language and published between 1995 and 2005. Based on these findings, we developed a postgraduate advanced mental health nursing programme. FINDINGS:There were 490 articles related to 'nursing' and 'critical thinking'; 34 articles related to 'nursing' and 'critical reflection'; 23 articles related to 'nursing' and 'critical social theory'; 15 articles related to 'mental health nursing' and 'critical thinking'; and two articles related to 'mental health nursing' and 'critical reflection'. In the programme we developed based on these findings, students were facilitated to deconstruct concepts and knowledge integral to their own practice. In the reconstructive phase, students implement a change project in clinical practice, supported by a mentor. CONCLUSION:The deconstructive-reconstructive approach to the development of critical thinking skills provides advanced practitioner with the opportunity to integrate practice, theory and research.

背景与目标：

BACKGROUND & AIMS: :Great evolution has taken place in Orthopaedic Traumatology, regarding techniques, surgical means and equipment. However, we still encounter complicated cases of limb trauma that necessitate microvascular reconstruction. Through three different illustrative cases (one emergency foot revascularization by a free flap, covering an ankle arthrodesis and bridging the anterior tibial artery, one cure of a complex infected tibial non-union with extensive skeletal defect by double barrel fibular transfer and one osteo-chondral reconstruction of the scaphoid proximal pole using a vascularized graft harvested from the femoral medial condyle), the authors remind the Orthopaedic community about the benefits of microsurgery, especially if used in proper indication and timing. This article is a plea to preserve the knowledge and develop the technical abilities of microvascular techniques in the departments of Orthopaedics and Traumatology.

背景与目标： : 在技术，手术手段和设备方面，骨科创伤学发生了巨大的发展。但是，我们仍然遇到复杂的肢体创伤病例，需要进行微血管重建。通过三个不同的说明性案例 (一个紧急的足部血管重建通过游离皮瓣，覆盖踝关节固定术并桥接胫前动脉，通过双桶腓骨转移和使用从股骨内侧髁收获的血管化移植物对舟状骨近端极进行一次骨软骨重建，一种复杂的感染胫骨不愈合的广泛骨骼缺损的治疗方法)，作者提醒骨科界关于以下方面的好处显微外科手术，特别是如果用于适当的指示和计时。本文旨在保留骨科和创伤科微血管技术的知识并发展其技术能力。

BACKGROUND & AIMS: PURPOSE OF REVIEW:Laparoscopic reconstructive urology is a challenging and technically demanding field of urology. As urologists' experience strengthened and technical modifications developed, urologic laparoscopy was applied in the treatment of malignancies and evolved from simple to technically demanding reconstructive techniques. This article reviews the latest published literature in the field of laparoscopic reconstructive urology and introduces our own persuasion for the role of this approach in urology. RECENT FINDINGS:Some laparoscopic procedures like orchidopexy, ureterolithotomy, pyelolithotomy and pyeloplasty require "a middle class level of laparoscopic skills" whereas other reconstructive techniques such as radical prostatectomy and cystectomy and partial nephrectomy are technically demanding and are still being developed with promising results. The reconstructive part of partial nephrectomy is small and refers to good hemostasis whereas in radical prostatectomy and cystectomy, the reconstructive part--urethrovesical anastomosis and urinary diversion, respectively--is an important factor, affecting the patient's postoperative quality of life. SUMMARY:The development of new instrumentation as well as the amelioration of urologists' laparoscopic skills will pave the way for the establishment of laparoscopic reconstructive urology in everyday practice. So far, laparoscopic reconstructive urology seems to be a well tolerated and effective treatment modality but still with not a completely clear role.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Systematic reviews have established the short-term improvements of periodontal regenerative/reconstructive procedures compared to conventional surgical treatment in intrabony defects. However, a hierarchy of periodontal regenerative/reconstructive procedures regarding the medium- to long-term results of treatment does not exist. AIM:To systematically assess the literature to answer the focused question "In periodontitis patients with intrabony defects, what are the medium- and long-term benefits of periodontal regenerative/reconstructive procedures compared with open flap debridement (OFD), in terms of clinical and/or radiographic outcome parameters and tooth retention?" MATERIAL & METHODS:Randomized controlled clinical trials (RCTs), reporting on clinical and/or radiographic outcome parameters of periodontal regenerative/reconstructive procedures ≥ 3 years post-operatively were systematically assessed. Clinical [residual probing pocket depth (PD) and clinical attachment level (CAL) gain, tooth loss] and radiographic [residual defect depth (RDD), bone gain (RBL)] outcome parameters, were assessed. Descriptive statistics were calculated and Bayesian random-effects network meta-analyses (NMA) were performed where possible. RESULTS:Thirty RCTs, presenting data 3 to 20 years after treatment with grafting, GTR, EMD, as monotherapies, combinations thereof, and/or adjunctive use of blood derived growth factor constructs, or with OFD only, were included. NMA based on 21 RCTs showed that OFD was clearly the least efficacious treatment; regenerative/reconstructive treatments resulted in significantly shallower residual PD in 4 out 8 comparisons [range of mean differences (MD): -2.37 to -0.60 mm] and larger CAL gain in 6 out 8 comparisons (range of MD: 1.26 to 2.66 mm), and combination approaches appeared as the most efficacious. Tooth loss after regenerative/reconstructive treatment was less frequent (0.4%) compared to OFD (2.8%), but the evidence was sparse. There was only sparse radiographic data not allowing any relevant comparisons. CONCLUSION:Periodontal regenerative/reconstructive therapy in intrabony defects results, in general, in shallower residual PD and larger CAL gain compared with OFD, translating in high rates of tooth survival, on a medium (3-5 years) to long-term basis (5-20 years). Combination approaches appear, in general, more efficacious compared to monotherapy in terms of shallower residual PD and larger CAL gain. A clear hierarchy could, however, not be established due to limited evidence.

背景与目标：

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :The bilayered dermal substitute Integra (Integra Life Sciences Corp., Plainsboro, NJ) was developed and has been widely used as primary coverage for excised acute burns. Our take has been slightly different, finding it most useful in the management of complex soft-tissue loss and threatened extremities as the result of tendon, joint, or bone exposure. Often tasked to fill significant volume loss, we have become adept at stacked multiple-layer applications. Creative use of this material has resulted in unexpected successes with distal limb salvage; the technique takes its place beside adjacent tissue transfer, composite flaps, and vascular pedicle flaps in our burn reconstructive practice. A prospective registry (44 patients) has been kept during the past 7 years that catalogs wounds with complex soft-tissue loss treated with Integra grafts. Many of these patients were at risk of extremity loss because of exposed tendons, joints, or bone. Integra was applied after 1:1 meshing. With profound soft-tissue defects, multiple layers of Integra were serially applied 1 to 2 weeks apart for reconstitution of soft-tissue contours. Local Integra graft infections were managed by silicone unroofing followed by topical sulfamylon liquid dressings. Wounds addressed included fourth-degree burns, necrotizing fasciitis, pit-viper envenomations, and total abdominal wall avulsion in one patient after being run over by a bus. Patients generally were free of pain from their wounds during the maturation phase of the Integra neodermis. Restoration of tissue contour was significantly better when using multiple layers for deep defects. Second and third layers of Integra were successfully applied after an abbreviated first graft maturation period of 7 days. Epithelial autografts on multilayer Integra applications frequently "ghosted"; they would auto-digest to dispersed cells followed subsequently by the reappearance of a confluent epithelial layer. Final grafted skin morphology over palmar and plantar surfaces assumed the type and fingerprint pattern of the original tissues. Infections were readily visible. Early recognition kept them to easily treated circumscribed areas, which did not jeopardize the entire wound. Lengths of stay were long (range, 2-246 days) but not significantly greater than with traditional techniques. The specific reconstructive use of Integra permitted unexpected salvage of several threatened extremities by protecting exposed tendons, bones and joints. Long-term histologic examination revealed unexpected persistence of Integra collagen. Large volume loss wounds benefited from the ability to fill voids with multilayered applications.

背景与目标： : 双层真皮替代品Integra (Integra Life Sciences Corp.，新泽西州普兰斯伯勒) 的开发，已被广泛用作切除的急性烧伤的主要覆盖范围。我们的说法略有不同，发现它在处理复杂的软组织损失和由于肌腱，关节或骨骼暴露而受到威胁的四肢中最有用。我们通常负责填补大量的体积损失，我们已经擅长于堆叠的多层应用程序。创造性地使用这种材料在远端肢体抢救方面取得了意想不到的成功; 在我们的烧伤重建实践中，该技术取代了相邻的组织转移，复合皮瓣和血管蒂皮瓣。在过去的7年中，已经保留了一个前瞻性注册表 (44名患者)，该注册表将用整合体移植物治疗的复杂软组织损失的伤口分类。这些患者中的许多人由于肌腱，关节或骨骼暴露而处于肢体丧失的风险中。1:1网格化后应用Integra。对于严重的软组织缺损，间隔1至2周连续应用多层整合体以重建软组织轮廓。局部整合性移植物感染通过有机硅去顶，然后进行局部磺胺的液体敷料来管理。处理的伤口包括一名患者被公共汽车撞倒后的四度烧伤，坏死性筋膜炎，腹蛇毒液和全腹壁撕脱。在整合型新真皮的成熟期，患者的伤口通常没有疼痛。当使用多层深部缺损时，组织轮廓的修复效果明显更好。缩短了7天的第一个移植物成熟期后，成功地应用了第二层和第三层Integra。多层Integra应用上的上皮自体移植经常 “重影”; 他们会自动消化成分散的细胞，然后重新出现汇合的上皮层。手掌和足底表面的最终嫁接皮肤形态假定原始组织的类型和指纹模式。感染很容易看到。早期的识别使他们能够轻松治疗外接区域，这不会危及整个伤口。停留时间长 (范围，2-246天)，但不显著大于传统技术。通过保护裸露的肌腱，骨骼和关节，对Integra的特定重建使用可以意外挽救几个受威胁的四肢。长期的组织学检查显示整合胶原的持续存在。大量损失的伤口受益于通过多层应用填充空隙的能力。

BACKGROUND & AIMS: Periosteum consists of multipotent mesodermal cells, and the influence of the environment on differentiation of cells of free periosteal grafts has been demonstrated in experimental studies. Periosteum has the capacity to form all varieties of connective tissue. The periosteum has osteogenic capacity, but it can also be used to promote cartilage formation in a chondrotrophic environment. Free periosteal grafts transplanted to the completely chondrectomized articular surfaces of patellae in experimental animals differentiated into cartilage. Joint motion appeared to be one of the chondrogenesis-promoting factors. The authors are optimistic about the potential clinical results with these types of grafts. Also, periosteal resurfacing of the metatarsal head was found to be suitable in the treatment of hallux rigidus and Freiberg's disease. Findings in growing rabbits showed that spinal fusion can be achieved with free periosteal grafts. This technique has been used to treat lumbar lytic spondylolisthesis in young patients, and the method produced clinical and radiologic results that were comparable with those obtained using bone transplants. This work indicates that some of the adverse effects of lumbar spinal fusion (e.g., postoperative spinal stenosis) can be avoided by using osteoperiosteal fusion. Also, periosteal grafting has proved useful in the treatment of thoracolumbar scoliosis. Free periosteal grafting has been used to treat congenital clefts of the maxilla and tracheal cartilage defects.

背景与目标： 骨膜由多能中胚层细胞组成，并且在实验研究中已经证明了环境对游离骨膜移植物细胞分化的影响。骨膜具有形成各种结缔组织的能力。骨膜具有成骨能力，但也可用于在软骨营养环境中促进软骨形成。在实验动物中，游离的骨膜移植物移植到完全软骨切除的髌骨关节表面，分化为软骨。关节运动似乎是促进软骨形成的因素之一。作者对这些类型的移植物的潜在临床结果持乐观态度。此外，还发现跖骨头的骨膜表面置换适合治疗拇趾和弗赖贝格病。生长中的兔子的发现表明，游离骨膜移植物可以实现脊柱融合。该技术已用于治疗年轻患者的腰椎滑脱症，该方法产生的临床和放射学结果与使用骨移植获得的结果相当。这项工作表明，使用骨骨膜融合术可以避免腰椎融合术的某些不利影响 (例如，术后椎管狭窄)。此外，骨膜移植已被证明可用于治疗胸腰椎脊柱侧凸。游离骨膜移植已用于治疗先天性上颌骨裂隙和气管软骨缺损。