Objective To discuss the repairing methods of the wound after upper lip lesion excision.Methods The wound after upper lip lesion excision was repaired by expanded pedicled submental flap.The 3 cm-long incision was located in 1 cm to sub-mandible.The 100 ml expander was placed beneath the platysma,and the aqueducts and spigots of the expanders were laid out of the skin.After complete expansion,the spastic scars of the upper lip and nasal bottom were resolved,the nasal columella and upper lip were put back to the normal position.The pedicled submental flap was transferred to the wound after upperlip excision according to the size of the wound.The pedicle was severed after 3 weeks.Results There were 5 cases of the expanded pedicled submental flap to repair the wound after upper lip excision.The flap survived without complications.The appearances were satisfied by the patients.Conclusions The method of the expanded submental flap is suitable for the wound after upper lip excision.

Objective To explore the repair method for wounds after excision of facial benign tumors.Methods Unilateral or bilateral deltopectoral skin flaps were expanded depending on the area of the facial benign tumor.Expander was implanted underneath deltopectoral flap region through an incision inferior to the clavicle.When expansion was completed,all or part of the benign tumor was excised before designing the flap according to the area of the skin defect.The area of the skin flap should be more than that of skin defect with 10％ to 15％.The pedicle wound could be sealed by rolling it around to form a tube or a hinge using the benign tumor and pedicle.The flap was delayed three weeks later and the pedicle was divided one week after flap delaying.Results All 20 cases got the satisfactory results with treatment of pedicled expanded deltopectoral skin flaps for repair of wounds after excision of facial benign tumor.Conclusions It is a better option to repair a large area wound after excision of facial benign tumor with an expanded deltopectoral skin flap.

Objective To investigate the efficacy and safety of enriched-calorie formula in post-operative infants with congenital heart disease and malnutrition.Methods All malnourished infants less than 6 months diagnosed congenital heart disease: ventricular septal defect and had undergone surgery in Guangzhou Women and Children`s Medical Center from December 1,2014 to May 30,2015 were included in this study.All cases were randomly divided into intervention group(energy-enriched formula,intervention group)and control group(standard formula,control group)for enteral nutrition intervention and observed for 3 months.Body mass,body length,upper arm circumference,blood prealbumin(PA),retinol binding protein(RBP),and B-terminal pro-brain natriuretic peptide(NT-proBNP)were measured before and after ICU,after discharge,and 1 month and 3 months after operation.Results Fifty-one cases were in intervention group and 50 cases in control group,respectively.There were no significant differences in body mass,body length,arm circumference,PA,RBP,mean enteral nutrition starting time,mechanical ventilation time,length of ICU stay,hospitalization time,and average fluid intake between the two groups(all P>0.05).The average caloric intake in intervention group was significantly higher than in control group [(437.24±6.68)kJ vs.(312.43±86.22)kJ,P=0.001].There was no significant difference in NT-proBNP,PA,and RBP at different time points between the two groups(all P>0.05).The improvement of nutrition in intervention group was significantly higher than that in control group at 1 month(25.0％vs.4.9％,P=0.011)and 3 months(64.1％vs.15.7％,P<0.001)after operation.Body mass increased in intervention group [(0.067±0.348)kg] compared with that in control group,and decreased [(0.125±0.425)kg] in control group(P=0.015).Body weight[(5.46±1.36)kg vs.(4.80±1.01)kg,P=0.008],weight for age Z score(WAZ)(-2.79±1.28 vs.-3.75±1.27,P<0.001),and height for weight Z score(WHZ)(-2.47±1.43 vs.-3.62±1.77,P=0.001)one month after surgery were significantly higher than those before operation.Body weight [(6.78±1.42)kg vs.(5.72±1.01)kg,P<0.001] arm circumference [(12.80±1.17)cm vs.(12.00±0.90)cm,P<0.001],WAZ(-1.60±1.17 vs.-3.10±1.40,P<0.001),height for age Z score(HAZ)(-1.41±1.63 vs.-2.10±1.41,P=0.034),and WHZ(-0.86±1.31 vs.-2.59±2.13,P<0.001)of the two groups at 3 months postoperative were significantly higher than those before operation,and the growth rate of intervention group was faster than control group.There were no significant adverse reactions in both groups.Conclusion Calorie-enriched formula powder can help malnourished infants to catch up after congenital heart disease surgery.

Objective: To explore the mechanism of traditional Chinese medicine(TCM) combined with regular therapy in the treatment of pneumonia with systemic inflammatory response syndrome(SIRS) in(children).Methods: Sixty-four children with pneumonia including 51 cases with SIRS complication were(randomly) divided into three groups: treatment group(regular therapy+TCM,n=26),control group Ⅰ((regular)(therapy) only,n=25) and the control groups Ⅱ(13 pneumonia children without SIRS(receiving)(routine) treatment). The dynamic changes of tumor necrosis factor-?(TNF-?),interleukin-6(IL-6) and IL-8 were measured before and after treatment in all children.Serum Creactive protein(CRP) and total white blood cell(WBC) count were measured simultaneously.Clinical symptom and sign scores were(performed)(5 days) after treatment in children with pneumonia and SIRS complication.Results: Before(treatment),serum TNF-?,IL-6,IL-8 and CRP concentrations were significantly higher in treatment group and(control) group Ⅰ than(control) group Ⅱ(all P

Objective To investigate the application of the frontal branch of superficial temporal vessels pedicled flap in repairing lower eyelid ectropion.Methods Eight cases were collected from patients diagnosed with lower eyelid ectropion in our hospital from April 2012 to April 2015.In phase 1 of operation,the dilators were implanted into the frontal branch of superficial temporal vessels and fully expanded by normal saline injection;In phase 2,the scar of lower eyelid was incised,and the expanded forehead flaps were transferred to cover the wound after the lower eyelid released back to normal anatomy location;In phase 3,the flap delay operation was manipulated 3 weeks after phase 2,and the left wound after scar excision was finished by pedicle division 1 week later.Results All patients in the study showed a good appearance and function of lower eyelid.There were no complications such as flap congestion and necrosis occurred.Meantime there were no relapses observed according to the follow-ups ranging from 6 months to 1 year.Conclusions The application of the frontal branch of superficial temporal vessels pedicled flap shows a promising procedure in treatment of lower eyelid ectropion.

Objective To investigate the application of expanded local flap in repairing extremity scars.Methods Thirty patients with extremity scars contracture as a result of trauma,surgery or infection during July 2000 and March 2013 were included.There were 11 male and 19 female patients with age ranging from 11 to 34 years.Tissue expansion,scar resection,flap transfer and scar management were involved in this process.Results There 24 patients suffered from upper extremity scars and 6 patients suffered from lower extremity scars.Expander exposure was noted in 3 patients,and 3 patients suffered from infection during the expansion.During the 6-month to 1-year follow-up,all patients satisfied with the results in terms of the skin texture,color,flexibility after the treatment with expanded local skin flap.Conclusions The expanded local flaps are suitable for the repair of the longitudinal and oblique scars in the extremities.

Objective:To observe the denervation and reinnervation of the neuromuscular junction (NMJ) and muscle spindle after sciatic nerve crush in mice.Methods:From January, 2019 to October, 2019, 18 C57BL/6 mice were randomly and evenly divided into injured groups (sciatic nerve crush group, 12 mice) and control groups (sham group, 6 mice). Mice in the injured group were sacrificed at day-1, day-2, day-3 and 4 weeks after the sciatic nerve injury. Mice in the control group were sacrificed at day-3 and 4 weeks from the day of experiment. The tibialis anterior muscles with crushed nerve were collected for immunohistochemistry staining by neurofilament (NF), synaptophysin (Syn) and α-bungarotoxin (α-BTX). Data were analysed by unpaired t-test. P<0.05 was considered significant difference. Results:The completely denervation of NMJ reached (92.4±8.85)% at day-3 after the nerve crush, compared with (5.19±1.32)% in the control group ( P<0.05). However, the muscle spindle lost γ-motor neuron innervation at day-2 after the nerve crush and completely denervated at day-3 after the surgery. For the reinnervation, no difference of no reinnervation of NMJ [(3.02±0.78)% vs. (4.22±2.08)%], partial reinnervation of NMJ [(6.44±1.91)% vs. (7.94±2.12)%] and completely reinnervation of NMJ [(90.54±10.44)% vs. (87.84±13.89)%] were observed between the control group and the injured group 4 weeks after the injury. While, for the muscle spindle, only the acetylcholine receptors at each end were partly reinnervated. The innervation of the middle part of the muscle spindle was thin and discontinued without typical spiral winding structure. Conclusion:The denervation speed of NMJ and muscle spindle was comparable after the peripheral nerve injury. The γ-motor neuron lost innervation ahead of the sensory neuron in the muscle spindle. The reinnervation of NMJ is earlier than that of the muscle spindle, and the re-innervation of the γ-motor neuron is prior to the sensory neuron in the muscle spindle.

Objective:To explore the feasibility, safety and effectivity of applying transmesenteric vein extrahepatic portosystemic shunt (TEPS) to treat extrahepatic portal vein obstructive disease (EHPVOD).Methods:From December 2020 to April 2021, 12 patients with EHPVOD in the Vascular Surgery Department of Zhengzhou University People′s Hospital were prospectively enrolled in the study. The infra-umbilical median longitudinal minilaparotomy was performed to expose the branch of superior mesenteric vein (SMV). RUPS-100 was introduced into the trunk of SMV. A balloon with a diameter of 20 mm was introduced through right internal jugular vein (RIJV) into inferior vena cava (IVC). Under fluoroscopy, RUPS-100 was used to puncture the balloon in IVC. A stiff guide wire was used to establish the pathway between RIJV and SMV. Finally the portosystemic shunt between IVC and SMV was established with a covered stent-graft. The total operative time, the time of establishing portosystemic shunt alone, the dosage of contrast agent, the preoperative and postoperative pressure of SMV were recorded. Paired t test was used to compare the preoperative and postoperative pressure of SMV. Results:All 12 patients were successfully performed TEPS. The total operative time was (113±32) min, the time of establishing portosystemic shunt alone was (31±5) min, the dosage of contrast agent was (129±48) ml. The postoperative pressure of SMV [(14.3±2.1) mmHg] decreased significantly ( t=20.125, P<0.01) compared to baseline [(27.8±2.7) mmHg]. All portal hypertension symptoms released after the operations.There was 1 case of delayed incision healing, 1 case of bacteremia and 1 case of slight hepatic encephalopathy, but all of them were cured. There was no death case. Postoperative CT showed all portosystemic shunts were patent. Conclusion:TEPS is a new, safe, effective and feasible treatment method for patients of acute and chronic EHPVOD.

Objective To investigate the characteristics of brain network based on brain electrical activity induced by somatosensory electrical stimulation,and to provide a theoretical basis for further understanding the mechanism of brain neural plasticity induced by somatosensory electrical stimulation.Methods Ten healthy subjects were selected and a somatosensory electrical stimulation experiment was constructed based on the directed transfer function (DTF).In the experiment,the DTF causal connection matrixes of the 32-channel EEG data of Delta,Theta,Alpha and Beta bands were obtained under the somatosensory electrical target and non-target stimulation,and the differences of clustering coefficient and global efficiency between two stimulation states were contrasted based on graph theory.Results Under the target stimulation and non-target stimulation states,the regions with stronger DTA causal connections were mainly concentrated in FCz,Cz,CPz and Pz channels.The causal connection intensity under target stimulation state was greater than that of non-target stimulation.Also,in the Delta,Theta,and Alpha bands,the clustering coefficient under the target stimulation state was significantly higher than that in the non-target stimulation state (P＜0.05).In the Delta and Theta bands,the global efficiency of the target stimulation state was significantly higher than that of the non-target stimulation state (P＜0.05).Conclusions Somatosensory electrical stimulation can activate and induce EEG brain networks.In the target stimulation state,the role of the parietal lobe in the EEG causal network is enhanced,which helps to induce attention to specific brain region plasticity,and thus realizing the nerve rehabilitation in the brain regions of interest.While in the non-target stimulation state,the synergistic interactions between brain regions were enhanced,which helps to activate and induce a wide range of associations in the whole brain network,so as to promote the global neural activity in the brain.

Objective The single-trial extraction method of evoked potential has been one of the problems in EEG information processing field.According to the characteristics of somatosensory evoked electroencephalogram (EEG) with low signal-to-noise ratio and large parameter variation between trials,a novel single-trial extraction method for evoked potentials was proposed.This method aims to further improve the accuracy and characteristics of the single-trial extraction algorithm,preserve more dynamic characteristics between trials,and improve the estimation accuracy.Methods Based on wavelet filtering and multiple linear analysis,a new single-trial extraction method for EEG P300 parameters was proposed by applying the adaptive dynamic feature library.Four groups of wavelet filtered evoked EEG data were randomly selected,and used to build the feature library using overlapping average method and principal component analysis.For the single-trial extracted EEG data,the component with the highest correlation coefficient related with the current data was selected as the independent variable from the feature library,and the relevant multiple linear regression analysis was conducted.The single-trial evoked potential signal was reconstructed by the regression analysis results,in which the key features such as latency and amplitude were automatically extracted.Results Compared with the benchmark values determined by experts,the proposed algorithn can obtain more accurate estimation values of latency and amplitude in P300 components.The average difference of latency and amplitude by the proposed algorithm is (11.16±8.60) ms and (1.40±1.34)μV,respectively.These two values obtained by the proposed algorithm are much closer to that obtained by the commonly used overlapping average method of (23.26±25.76) ms and (2.52±2.50) μV,respectively.These results show that the proposed algorithm has significant advantages comparing with the traditional multiple linear regression analysis algorithm.Conclusions The dynamic updating principal component sample library of EEG data was applied to wavelet filtering and multiple linear regression,thus the dynamic characteristics were effectively preserved,and the accuracy of parameter estimation was improved.