Objective To investigate the outcome of free posterolateral leg perforator flap in the reconstruction of soft tissue defects of oral and maxillofacial area.Methods From February,2014 to August,2016,16 patients were performed defect reconstruction following oral cancer ablation with free posterolateral leg perforator flap including 3 cases of sequamous cell carcinoma of the tongue,6 cases of carcinoma of the buccal mucosa,7 cases of sequamouse cell carcinoma of the floor of mouth.The flap ranged from 5.0 cm×3.0 cm to 13.0 cm ×9.0 cm in size,and were adjected to the soft tissue defects of oral and maxillofacial area.The outcome of reconstruction was evaluated by considering the facial appearance,the swallowing and the speach function,the ranges of mouth opening and patient prognosis.Results All 15 transplanted flaps survived well and only 1 survived after disposing in time,because of vascular crisis.The donor sites were closed directly without donor-site morbidity.All patients were satisfactory with their facial appearance,the ranges of mouth opening and swallowing and speech function.Conclusion The free posterolateral leg perforator was an ideal free tissue for repairing functionally oral and maxillofacial defects,sinceit including some beneficial characteristic such as constant blood vessel,flexible and divese design,abundant and position-latent donor site tissues,small operation loss,flexible preparation and loss of major vascular nerves.

OBJECTIVE To investigate the use ofultrasonically activated scalpel (UAS) in open thyroid surgery. METHODS From February 2004 to March 2005, thyroidectomy were performed in 77 cases by the same operation team. Forty seven cases received UAS thyroidectomy and 30 cases underwent conventional thyroidectomy. The operation time, estimated blood loss in operation, postoperative draining volume within the 24 hours, the length of hospitalization and postoperative complications between two groups were compared. RESULTS The average operation time of lobectomy and total/subtotal thyroidectomy in the UAS group were 61?4.34 and 85?3.02 minutes, and in conventional group were 82?3.37 and 121? 2.51 minutes. There was a significant difference in average operation time (P0.05). CONCLUSION The use of UAS in thyroid surgery was safe and can reduce the operation time.

Objective The Nuss procedure is a minimally invasive pectus repair.The aim of this study was to explore the changes in quality of life in patients who underwent a Nuss procedure.Methods 96 patients,who underwent a Nuss procedure in our institution,were interviewed at preoperation,1 year after operation with the bar in place,and before the planned bar removal.The Nuss Questionnaire modified by George Krasopoulos et al,which evaluates psychosocial and physical well-being,was independently used by patients.Results Most of the scoring of the individual questions and the total score of individual patients revealed a significant improvement,both in preoperation vs.1 year after operation and 1 year after operation vs.before the planned bar removal.Conclusion The Nuss procedure has been shown to improve the quality of life in patients with pectus excavatum deformity in the short term.

To evaluate the clinical effect of application of free peroneal artery perforator flap in repairing postoperative tissue defect after resection of oral maxillary malignant tumor. Methods From January, 2016 to June, 2018, 14 patients with maxillary malignant tumor were treated with tumor excision. Then the free per-oneal artery perforator flap was used to reconstruct tissue defect caused by tumorectomy. There were 6 cases of squa-mous-cell carcinoma of palatine, 2 cases of adenoid cystic carcinoma of palatine, and 6 cases of maxillagingiva squa-mous cell carcinoma. The incised area of flap was 4.0 cm×5.0 cm to 7.0 cm×8.0 cm. There were 5 cases of hard palate soft tissue defect repair and 9 cases of simultaneous repair of soft and hard palate. Followed-up by outpatient service in 3-12 months after operation, postoperative maxillamorphology, phonetic function, swallow function, opening degree and prognosis of the patients were evaluated. Results All 14 implanted flaps were alive.One flap had vas-cular crisis, and rescued by surgical exploration and timely rescue.Three flaps were prolonged healing.All donor sites were sutured directly.All surgical incisions healed primarily.Half a year after the operation, the appearance of maxilla was formed gradually. The phonetic function, swallowing function, opening degree and movement of lower leg were all recovered normal. One year after the operation, epithelization was done in 6 cases. And there was no tumor recur-rence.Conclusion The peroneal artery perforator flap has long vascular pedicle, larg diameter, high survival rate after vascular anastomosis and relatively concealed donor area. It can be used to repair and reconstruct the tissue defect in maxillary malignant tumor resection and achieved good result.

Objective To evaluate the effect of double-leaf perforator free flap pedicled with posterolateral calf peroneal artery on repairing facial through-and-through defect after oral cancer oblation.Methods Nine patients with facial through-and-through defects after oblation of oral and maxillofacial malignancies,including 4 cases of buccal mucosa carcinoma,2 cases of maxilla osteosarcoma,1 case of carcinoma of the maxillary sinus and 2 cases of parotid duct carcinoma,were recruited from May,2016 to May,2018.The flap was used to repair the facial defect of recruited patients.The area of the bigger leaf of bilobed perforator flap was 7.0 cm×8.0 cm-6.0 cm×7.0 cm and the small leaf was 4.5 cm×4.5 cm-4.0 cm×4.0 cm,respectively.The intraoral and facial defects needed to be reconstructed contained the oral mucosal of the upper palate,the skin,subcutaneous tissue and mucosa of the cheek.The radiotherapy was performed 1.0-1.5 months after the operation.The prognosis including appearance,mouth opening,and the functions of deglutition,and language were assessed.Results Through 3-18 months outpatient followed-up,all 9 cases of transplanted flaps survived well and the incisions of the donor and recipient areas healed by first intention.The patients were satisfied with the facial appearance,mouth opening,and the functions of deglutition and language at the 6 months follow-up.The radiotherapy had no damage on the survival of the bilobed perforator flap.There was no recurrence or metastasis in follow-up.Conclusion The double-leaf perforator free flap pedicled with posterolateral calf peroneal artery is an ideal free tissue for repairing the facial perforating defect after oral cancer oblation because of its constant blood vessel,abundant tissues,flexible design and operating methods.

Objective To explore the effects of bronchoalveolar lavage combined with microbiological rapid on-site evaluation in potential donor lung maintenance.Methods Brain death patients who met the inclusion criteria and were admitted to the Intensive Care Unit(ICU)of Calmette Hospital Affiliated to Kunming Medical University from September 2020 to December 2022 were selected for bronchoalveolar lavage(BAL)and(BAL)and the lavage fluid were collected for M-ROSE to compare the pathogen detection rate and initial diagnosis time.According to the positive results of the microbiological rapid on-site evaluation,patients with the brain death were treated with empirical anti-infective therapy,and the oxygenation index,chest X-ray score,and the infection index(WBC,CRP,PCT)of anti-infective treatment 48 hours were evaluated.Results 1.Comparison of the detection rate of pathogenic microorganisms:The results of M-ROSE were highly consistent with a routine microbiological smear(Kappa = 0.921,P<0.001).2.Comparison of diagnostic time:The initial diagnosis time of M-ROSE was significantly lower than routine microbiological smear time and microbial culture time(P<0.001).3.Comparison of therapeutic effects of anti-infective therapy for 48 hours:There was no significant difference in oxygenation index,white blood cells and hypersensitive C-reactive protein before and after the anti-infective treatment(P>0.05).There were significant differences in procalcitonin and chest X-ray before and after the anti-infective treatment(P<0.05).Conclusion Bronchoalveolar lavage combined with microbiological rapid on-site evaluation has the high timeliness in the diagnosis of potential donor pulmonary infection,which can provide a preliminary basis for the early anti-infective therapy of donor lung maintenance.

Objective: To investigate the mechanism of lncRNA XIST (XIST) on modulating gastric cancer progression via regulating miR-337-3p/HOXC8 axis. Methods: A total of 58 cases of gastric cancer tissues and corresponding para-cancerous tissues resected from March 2013 to January 2018 in Department of General Surgery, Kailuan General Hospital of Tangshan City were collected for this study; in addition, human gastric cancer cell lines (AGS, MGC803, HGC27) and human gastric mucosal GES-1 cells were also collected. qPCR was used to detect the expressions of XIST and miR-337-3p in above mentioned gastric tissues and cell lines. XIST-knockdown vectors, miR-337-3p mimics, miR-337-3p inhibitor and HOXC8-overexpression vectors were transfected into AGS cells. The proliferation and invasion of AGS cells were detected by CCK-8 and Transwell experiments respectively, and the expression levels of HOXC8, E-cadherin, N-cadherin and vimentin were detected by WB. The targeting relationships between XIST, miR337-3p and HOXC8 were verified by dual-luciferase reporter gene assay. Results: XIST was up-regulated in gastric cancer tissues and cell lines (all P<0.01). XIST knockdown significantly inhibited proliferation, invasion and EMT of AGS cells (P<0.05 or P<0.01). Moreover, XIST directly interacted with miR-337-3p and down-regulated its expression, while HOXC8 was the target gene of miR-3373p. Furthermore, XIST knockdown suppressed proliferation, invasion and EMT ofAGS cells through up-regulating the inhibitory effect of miR-337-3p on HOXC8 (P<0.05 or P<0.01). Conclusion: XIST knockdown can suppress the proliferation, invasion and EMT of AGS cells, which may be related with down-regulation of HOXC8 by targeting miR-337-3p.

OBJECTIVE: To evaluate the effect of using free double- leaf perforator flap posterolateral calf peroneal artery in anatomical reconstruction of the oropharyngeal structure after ablation of advanced oropharyngeal carcinoma. METHODS: Twenty-six patients with oropharyngeal defects after ablation of oropharyngeal malignancies were recruited, including 12 with carcinoma in the tongue base, 5 in the latenral pharyngeal wall and 9 in the soft palate. Between July, 2016 and July, 2018, the patients underwent surgeries for reconstruction of the oropharyngeal defects using flaps. The areas of tissue defects repaired by double-leaf perforator flaps ranged from 40.5 to 72.5 cm. Reconstruction was performed for oropharyngeal defects in the soft palate, pterygopalate, parapharyngeal, pterygo- mandibular, and tongue base tissues. The patients' outcomes including mouth opening, functions of deglutition, linguistic function, restoration of palatopharyngeal anatomical structure and postoperative survival were evaluated, and their quality of life was assessed using FACT-H&N scale (Chinese Edition). RESULTS: All the 26 patients with transplantation of the free flaps survived. Six months after the operation, the oropharyngeal function and anatomical structure of the patients were basically restored. The questionnaire survey showed that the patients' physical, social/family, emotional and functional conditions, the total score of the core scale, items scores for the head and neck, and the total score of the scale all improved significantly after the operation compared with those before the operation ( < 0.05). CONCLUSIONS The free peroneal artery bilobate perforator flap in the posterolateral crus, which seldom has anatomical variations of the blood vessels, allows flexible design and contains rich tissue volume to facilitate defect repair with different approaches and ranges. The application of this flap, which is an ideal perforator flap for reconstruction of the oropharyngeal structure and function, can improve the quality of life of patients following operations for advanced oropharyngeal cancer.
Arteries ; Free Tissue Flaps ; Humans ; Oropharyngeal Neoplasms ; Perforator Flap ; Quality of Life ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries