OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

Objective To evaluate the efficacy and safety of acute ureteroscopy for the treatment of ureterie stones during middle and late pregnancy.Methods From June 1998 to March 2005,17 pregnant women(mean age,27 years;age range,21-35 years)with ureteric stones were treated by ureteroscopy when the fetus was at 20-36 weeks of gestation(mean,29 weeks).All the cases presented with urgent symptoms such as recurrent renal colic(11 cases),fever(4)or acute obstructive anuria(2).Among 17 cases,the stones(between 6 mm?7 mm and 13 mm?21 mm)were located in the upper(8 cases),middle(5)or lower ureter(4);and on the left side(5 eases),on the right(10)and on both(2)of the lower ureter. Mild hydronephrosis were observed in 6 cases and moderate hydronephrosis in 11,Of the 17 cases,14 under- went ureteroscopic pneumatic lithotripsy;in 1 case the calculi were pushed to the renal pelvis;and 2 cases were treated by Double-J catheter drainage.Results All the urgent symptoms in 17 cases were relieved after treatment.The stone-free rate of initial treatment was 82.4%(14 of 17).Three cases with residual stones were treated by Douhle-J catheters,which were replaced every 3 months until the calculi were re- moved.No abortion,premature delivery or complications such as ureter perforation occurred.Mild renal colic occurred in 1 case after insertion of Douhle-J catheter,and it was relieved 3d later;gross hematuria occurred in l case and disappeared 6 d later without treatment.All 17 patients had normal delivery and gave birth to healthy children.Conclusions Ureteroscopy is a safe and reliable method for the treatment of ureteric calculi during middle and late pregnancy.

Depression is a serious mental illness with a high incidence. At present, we do not fully understand the specific pathological mechanisms of depression, and the efficacy of drug treatments is very limited. Recent studies have shown that epigenetic changes that occur in specific brain regions may be a key mechanism by which environmental factors to interact with individuals to influence the risk of depression. Therefore, drugs that target epigenetic regulation may become a new direction for the development of antidepressants. Histone deacetylase inhibitors (HDACi) are a class of compounds that inhibit histone deacetylase activity, which has been reported to be associated with depression; this article addresses the use of HDACi in preclinical studies, and their potential therapeutic role and limitations of use in depression.

A new experimental software of an X-ray machine's console virtual operation system based on VB is introduced. This software can simulate the manual operation on the X-ray machine's console, and has the characteristics of easy operation, multi-function and good interactivity.
Computer Simulation ; Software Design ; Tomography, X-Ray Computed ; instrumentation ; methods ; User-Computer Interface

OBJECTIVETo discuss the integrated autologous fat graft technique in face recontouring.

METHODSIn this study we treated 83 cases of face recontouring with 3L3M technique (low pressure suction, low speed centrifugation, low volume, multi-plane, multi-tunnel, multi-point injection). Each case was treated 1-3 times and the interval period is 3-6 months. The result was based on comparing the photos taken from pre-operation and post operation, observing the expression recovery, cysts, local absorption, and patients self evaluation.

RESULTSLong time follow up showed that fat graft can be alive in the recipient site for long time after 1-3 times autologous fat injection. More than 73.5% patients were satisfactory with the curative effect while less than 4.8% patients were unsatisfactory.

CONCLUSION3L3M integrated fat graft technique is an effective and safe treatment in face recontouring.

Adipose Tissue ; transplantation ; Adolescent ; Adult ; Face ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

Objective Few studies are reported on the factors influencing the selection of the surgical access for adenocarci-noma of the esophagogastric junction (AEG). This study aimed to investigate the factors influencing the selection of the surgical access for CT type-ⅡAEG. Methods We retrospectively analyzed 118 cases of CT type-ⅡAEG surgically treated in the Second Affiliated Hospital of Zhengzhou University and Henan Tumor Hospital from January 2015 to January 2017,92 via the abdominal access and the other 26 via the thoracoabdominal access. We performed univariate and multivariate logistic regression analyses on the factors that might influence the surgical approaches,such as gender,body mass index (BMI),degrees of the epigastric angle,pathological classifica-tion,and clinical stages. Results Logistic regression analysis showed that the degree of the epigastric angle was an independent fac-tor influencing the selection of the access of AEG (OR=0.250,95% CI: 0.098-0.639) (P<0.05). Conclusion In the surgical treatment of CT type-ⅡAEG,the abdominal access is preferable for patients with the epigastric angle> 90 degrees and the thoracoab-dominal access is recommended for those with the epigastric angle≤90 degrees.

Objective To investigate the long-term follow-up results of patients treated with radical nephrectomy for small renal carcinoma.Methods Between January 1992 and June 2004,a total of 56 pa- tients(41 men and 15 women;mean age,54 years;age range,19-71 years)underwent radical nephrectomy for small renal carcinoma.The clinical data and long-term follow-up results of the 56 cases were analyzed ret- rospectively.All the patients were followed by questionnaire;and the 5-and 10-year survival rates were calcu- lated by Kaplan-Meier method.Results None of the patients was found to have metastasis preoperatively. Postoperative pathology showed renal clear cell carcinoma in 44 cases,granular cell carcinoma in 7,and mixed cell carcinoma in 5.Among these cases,ipsilateral adrenal metastasis was found in 1 case,local lymph- aden metastasis in 2,and perirenal fat metastasis in 4.Postoperatively,49 of the 56 patients(87.5%)were followed for 11-155 months with a mean of 71 months.The 5-and 10-year survival rates were 81.7% and 66.9%,respectively.Five patients died of metastasis from renal carcinoma.Conclusions Radical ne- phrectomy for small renal carcinoma has favorable long-term effects,therefore it is an optimal surgical proce- dure for small renal carcinoma.

Anaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma (DLBCL) is a rare and distinct variant of DLBCL. It is classified as a unique subtype of DLBCL in the 2008 WHO classification of lymphomas. No standard and effective therapeutic regi-men is available for ALK+DLBCL because it shows a more aggressive clinical course and frequent relapse. Therefore, a standardized and individualized treatment is needed to benefit more patients diagnosed with ALK+DLBCL through a multiple disciplinary team. This arti-cle presents a case of an ALK+DLBCL patient who relapsed after transplantation and was successfully treated with the ALK kinase inhibi-tor Crizotinib.

OBJECTIVESTo investigate the difference of BPH incidence in two groups.

METHODS309 cadres and 314 farmers over 60 years old in district of Wannan have been investigated. The investigation included prostate volume (V), IPSS, L, Qmax, residual urine (R) and dietary constituents.

RESULTSThe intake of animal protein in cadres is more than that in farmers (u = 24.10, P < 0.01), and the incidence rate of BPH is significantly higher (91.1% vs 11.8%, chi 2 = 24.64, P < 0.001). Logistic regression shows that the intake of animal protein has a parallel relationship with BPH.

CONCLUSIONSIn the district of Wannan, the incidence of BPH in cadres is significantly higher than that of farmers, and it may be correlated with the amount of animal protein intake.

Aged ; China ; epidemiology ; Diet ; Humans ; Incidence ; Male ; Middle Aged ; Prostatic Hyperplasia ; epidemiology ; Rural Population ; Urban Population

OBJECTIVE To observe the cross section diameter and the effects of pricking blood therapy on acute gouty ar-thrits rats model's interleukin-1β(IL-1β),interleukin-10(IL-10)mRNA expression and promoter methylation in local ankle,and explore the epigenetics mechanisms of pricking blood therapy's treatment.METHODS 36 SD rats were randomly divided into normal control group,urate arthritis group,ibuprofen group and bloodletting group.The acute gouty arthrits model set up by injecting uric acid into the right ankle joint cavity.The ibuprofen group was treated by gastric perfusion of ibuprofen,while the bloodletting group was pricked at the right Kunlun points.The swelling index of the modeling joint was evaluated,and the morphological changes were observed under light microscope.The mRNA expression levels and promoter methylation status of IL-1βand IL-10 in rats local ankle were detected by qPCR and pyrosequencing detection.RESULTS Compared with the urate arthritis group and ibuprofen group,the joint swelling index in the bloodletting group was decreased(P<0.01)after the treatment.Pricking blood therapy reduced intracellular deposition of uric acid in the joint cavity,and inhibited inflammato-ry cells to improve the synovial membrane tissue.Compared with urate arthritis group,the IL-1βmRNA expression levels of blood group was decreased significantly(P<0.01).IL-1βpromoter methylation and mRNA expression didn't showed a nega-tive correlation.Compared with normal control group,urate arthritis group and ibuprofen group,the expression levels of IL-10 mRNA in blood group increased significantly(P<0.01),and the average methylation rate of IL-10 among blood group de-creased significantly(P<0.05～0.01).IL-10 promoter methylation and mRNA expression showed a strong negative correla-tion(r=-0.899,P<0.01).CONCLUSION In epigenetics,the methylation of IL-10 can regulate the gene expression,which can be one of important mechanisms which shows anti-inflammatory effects of pricking blood therapy,.