Objective To probe the effect of perioperative therapeutic regime on breast reconstruction after surgery in breast cancer patients.Methods We retrospectively reviewed the clinical data of 145 consecutive breast cancer patients with 162 reconstructions.Results 127 of 145 patients got an excellent or good appearance (87.6％),and 42 cases had complications occurring in 162 operations (25.9％).After a median follow-up of 38.4 months,recurrences were found in 9 patients,3 cases died,and the disease free survival rate was 93.1％.Multivariate analysis showed that radiation therapy,without nipple-sparing and one-stage prosthesis implant were independent risk factors for negative postoperative aesthetic outcome;Delayed reconstruction and implant reconstruction were found to be protective factors for the postoperative complications.Conclusions Although the survival rate appears to be scarcely affected,different treatment modalities in reconstruction strategy bring different clinical results and outcomes.The perioperative decision-making of reconstruction strategy should be based on oncological safety,postoperative complications,aesthetic outcomes and subsequent therapies.

Objective To evaluate the therapeutic effect of long-pulsed Nd:YAG 1064 laser on hyperplastic scars by using a rabbit ear model.Methods Five female and five male New Zealand long-ear white rabbits weighting 2.0-2.5 kg were used in this experiment.Four square full-thickness skin wounds sized 1.5 cm x1.5 cm were created on the ventral surface of each ear to develop a model of hyperplastic scar.Finally,a total of 74 hyperplastic scars developed on the 80 wounds,and the scars on the left and right ears served as the control (unirradiated) and treatment (irradiated with long-pulsed 1064 nm Nd:YAG laser) group,respectively.After 30 days of irradiation,the color and texture of scars were observed and the scar thickness was measured by color Doppler ultrasonogTaphy.Then,the scars were harvested followed by the analysis of density of fibroblasts and microvessels as well as the changes in collagen fibers in scars by HE staining,CD31 staining and Masson staining,respectively.Results A decrease was observed in the color,hardness and thickness of scars in the irradiated ears compared with the unirradiated ears.The average thickness of scars,microvessel density and fibroblast density in scars were significantly lower in the treatment group than in the control group(2.137vs.3.089 am,t=5.72,P<0.01;38.333/mm2vs.68.056/mm2,t=4.93,P<0.01;166.940/mm2vs.355.000/mm2,t=13.36.P<0.01).Masson staining revealed a disorganized arrangement of collagen fibers in the control group but a sparse and regular alignment in the treatment group.Conclusion Long-pulsed 1064 nm Nd:YAG laser may promote the shrinkage and suppress the hyperplasia of scars.

Objective To improve lower eyelid blepharoplasty by using myocutaneous flap and lateral one-third skin flap.Methods A total of 37 patients were recruited in this study and received lower eyelid blepharoplasty.Incision was made at the lower palpebral margin,and the extension of incision was hided into the outer canthus rhytids.Myocutaneous flap was made first followed by the preparation of skin flap at the lateral one-third of the lower eyelid.Results All the patients experienced a quick recovery from the surgery.The excess skin at the lateral canthus was completely removed,the incision was sutured under moderate tension,and the eyelid skin was flattened.No lid-retraction or lower eyelid ectropion was observed in the 6-to 12-month postoperative follow-up.The lateral incision sear was hidden and the operation outcome was satisfactory.Conclusions The lower eyelid blepharoplasty with myocutaneous flap and lateral one-third skin flap may lead to a satisfactory outcome with the formation of natural outer canthus angle and make the patients younger.

Objective To study the lymphatic microvessel density of keloid and correlation of invasive growth.Methods Invasive part,proliferative part and peripheral normal skin of keloid patients (n=10) were collected by surgical excision,and normal skin of keloid and non-keloid patients as control.Lymphatic vessel density of different parts of keloid and normal skin were investigated by immunohistochemical staining using the lymphatic endothelium specific marker D2-40.Results There were no significant differences between lymphatic microvessel density of peripheral normal skin of keloid (12.563 ±1.803) n/mm2 and normal skin of non-keloid patients (11.071 ± 2.645) n/mm2 (t=1.389,P＞0.05); Lymphatic microvessel density of invasive part of keloid (27.315 ± 7.430) n/mm2 was significantly higher than those of proliferative part of keloid (17.375± 6.221) n/mm2 and normal skin (12.563±1.803) n/mm2 (x2 =16.8,P＜0.01); there were significant differences between proliferative parts of keloid and normal skin (t=2.276,P＜0.05).Conclusions Lymphatic microvessel density increase in the invasive part of keloid may have a certain relationship with invasive growth.

ObjectiveTo search for the optimum external masking time and tonal models for patients with tinnitus.MethodsTwenty-seven patients with cochlear tinnitus were selected respectively from three different out-patients departments and divided into three groups. Nine patients in every group were treated with different masking parameters according to factorial design which had three masking noises, i.e. narrow band noise (NBN), wide band noise (WBN), speech noise (SN),and three masking time ranges, i.e. 15,30,45 minutes. The results before and after treatment were compared and analysed with analysis of variance (ANOVA). ResultsThe treatment effect when masking for 15 minutes was worse than that for 30,45 minutes, but there was no difference between 30 and 45 minutes. The NBN had the best effect when tinnitus signal was single, the WBN was effective for tinnitus with multiple sounds. ConclusionNBN or WBN masking for 30 minutes showed better therapeutic effect.

Objective:To understand the current situation of human resources in the hemodialysis centers of different levels of hospitals in Beijing, and to provide reference data for themedical institutions at all levels to adjust the related human resources programs.Methods:Based on the self-designed questionnaire, the basic situation of 123 hemodialysis centers and the allocation of human resources of doctors, nurses and engineers in medical institutions of Beijing were investigated and analyzed.Results:Each nurse in hemodialysis center was responsible for (4.98± 0.74) hemodialysis patients at the same time in each treatment shift. The specialized nurses accounted for 23.32% of the total registered nurses. The ratio of engineers to dialysis machines was 1∶25.76. The proportion of doctors, nurses and engineers with intermediate professional titles or above was 82.47%, 33.08% and 29.81% respectively. The proportion of doctors with graduate education or above was 51.13%. The proportion of nurses and engineers with bachelor degree or above was 56.12% and 51.56% respectively. The differences in the professional titles and the highest academic qualifications of the employees (doctors, nurses and engineers) between tertiary hospitals and non-tertiary hospitals were statistically significant ( P < 0.05). Conclusion:The number of personnel in Beijing hemodialysis centers is basically in a similar proportion, but there are some differences between the hemodialysis centers of tertiary hospitals and those of non-tertiary hospitals in terms of age composition, working years, professional titles and educational background. It is necessary to optimize the allocation of human resources in hemodialysis centers of different levels of hospitals, further strengthen the training of professional talents and the cooperation of multidisciplinary teams, to promote the sustainable development of medical service quality.

Adult ; Aged ; Boronic Acids ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; complications ; drug therapy ; Pyrazines ; therapeutic use ; Renal Insufficiency ; complications ; drug therapy

Objective To study Medpor combined with autogenous outer table of calvarial in management of deformities secondary to orbitozygomatic fracture.Methods In the reconstruction of the orbitozygomatic fracture,we firstly did the operation of osteotomies to reset reliable internal fixation,then Medpor combined with autogenous outer table of calvarial was used to repair wall and in correction of depressed orbitozygomatic region.Results From January 2007 to December 2010,13 cases of deformities secondary to orbitozygomatic fracture were repaired.The enlarged orbital volume was reduced,enophthalmos and facial asymmetry were corrected or improved.Facial deformity was significantly improved and no complications occurred.Conclusions Medpor combined with autogenous outer table of calvarial is benefit to most of secondary deformities to orbitozygomatic fracture.It is an effective solution to the orbital content shift and double vision problem,and it also can reduce the autologous damage and foreign body rejection.

Objective To investigate the effects of microRNA-294 (miR-294) on tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) and high mobility group box 1 (HMGB 1) secretion in sepsis by targeting triggering receptor expressed on myeloid cell-1 (TREM-1).Methods miRNA-294 was predicted to regulate TREM-1 specially through bioinformatics analysis.Mice macrophage cell lines RAW264.7 were cultured in vitro,the cells were divided into non-inflammatory stage and inflammatory stage,and the cells in the two stages were subdivided into five groups as follows:normal control (NC),NC mimic transfection (NCm),NC inhibitor transfection (NCi),miR-294 mimic transfection (miR-294m) and miR-294 inhibitor transfection (miR-294i) groups.The ability of miR-294 was confirmed with dual-luciferase activity assay.At non-inflammatory stage,the cells were transfected with mimic or inhibitor of miR-294 or NC using TurboFectTM siRNA Transfection Reagent for 48 hours,mRNA expression of TREM-1 was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).At inflammatory stage,6 hours after stimulation by lipopolysaccharide (LPS,1 mg/L),the concentrations of TNF-α,IL-6 and HMGB1 were determined by enzyme linked immunosorbent assay (ELISA),the protein expression of TREM-1 was determined by Western Blot.Results ① Dual-luciferase activity assay demonstrated that TREM-1 was the target of miR-294.② In non-inflammatory stage,the expression of TREM-1 mRNA (2-ΔΔ~) in miR-294m group was significantly lower than that of the NC and NCm groups (0.673 ± 0.049 vs.1.000 ± 0.003,0.915 ± 0.039,t1=2.184,t2=5.421,both P＜0.001),the expression of TREM-1 protein (gray scale) was (50.00 ± 1.19)％ of NCm group (t=41.586,P＜0.001).③ In inflammatory stage,the concentrations of TNF-α (ng/L) in miR-294m group was significantly lower than that of the NC group (1 547.18 ±47.18 vs.2 702.11 ± 327.20,t=4.212,P=0.010),the concentrations of IL-6 (ng/L) was significantly lower than that of the NC and NCm groups (505.28 ± 33.33 vs.837.66 ± 69.43,918.72 ± 119.39,t1 =4.382,P1=0.015; t2=5.451,P2=0.021),the level of TREM-1 protein (gray scale) was (51.33 ±0.88)％ of NCm group (t=63.368,P＜0.001).Conclusion miR-294 reduce TNF-α and IL-6 secretion in LPS-induced RAW264.7 through inhibiting the expression of TREM-1 specifically.

Objective To investigate the effects of low dose of extracellular histone on endothelial cells in infectious diseases such as sepsis. Methods The endothelial cells were treated with 10 μg/mL recombinant human histone H3/H4 complex in replacement of calf thymus histones (CTH) for various periods of time, and the morphology changes and the viability of the endothelial cells were recorded. In addition, flow cytometry was applied to identify the characteristics of endothelial cells and enzyme-linked immunosorbnent assay (ELISA) was used to detect the extracellular histones level in endothelial cells culture. Results The low dose of CTH could continuously induce endothelial cells death, cell morphological changes and function loss, which was reproduced by 10 μg/mL recombinant histone H3/H4 complex. Results of histones quantitation showed that histone can cause a series of intracellular reactions in a short period of time. Conclusions It is showed that 10 μg/mL H3/H4 can induce the toxicity in infectious disease and this level of the dose is a lower than those used in previous studies and more close to the pathological conditions.