Objective To investigate the clinical features of patients with multiple sclerosis (MS) and restless legs syndrome (RLS) and to further examine relevant factors that may contribute to the co-occurrence of MS and RLS.Methods Seventy MS patients were recruited in the present study.The RLS screen was further performed in MS patients based on the diagnostic criteria for RLS.MS patients with RLS were designated as the case group and MS patients without RLS served as the control group.The clinical data including age of MS onset,MS duration and clinical disability by the expanded disability status scale (EDSS) were analyzed.Results There were 12 MS patients with RLS in total 70 MS patients and the incidence rate was 17.1％.The average age of MS onset in the RLS group was (47.6 ± 10.0) years,and (40.1 ± 10.4 ) years in the control group.The difference of average age of MS onset was found to be significant (t =2.29,P =0.030).The average history of MS in the RLS group was ( 12.6 ± 6.8 ) years,and ( 8.2 ± 6.6) years in the control group ( t =2.10,P =0.039).The average EDSS of the RLS group was 4.5 ±2.5,and 2.5 ±2.0 in the control group (t =3.02,P =0.004).There was no significant association between RLSRS and EDSS in MS patients with RLS (P =0.15).Conclusion The incidence rate of RLS in MS patients was high.Among patients with MS,RLS was associated with older age,longer MS duration,and more severe disability.

Objective In order to investigate the role of Gap Junction (GJ) in the generation and development of epilepsy,we examined the expression of connexin43 (Cx43)and Cx32 in the epileptogenic lesions and surrounding brain tissues of the patients with refractory temporal epilepsy.Methods Thirty intractable epilepsy patients were performed the resection of epileptogenic lesions under the ECC monitor.The expression of Cx43 and Cx32 in the epileptogenic lesions and the surrounding brain tissues of the patients were examined by immunohistochemical staining(the two step method).The data were statistically analyzed.Results The results from the immunohistochemistry staining showed that Cx43 and Cx32 were expressed in the epileptogenic lesions and the surrounding brain tissues.The expression of Cx43 in the epileptogenic lesions was increased obviously in comparison with the surrounding brain tissues ( U =4.066,P ＜ 0.001 ).There was no significant difference in the expression of Cx32 between the epileptogenic lesions and the surrounding brain tissues ( U =1.866,P ＞ 0.05 )Conclusion The expression of Cx43 in the epileptogenic focus is increased in comparison with that in the surrounding brain tissues,indicating that GJ plays an important role in the generation and development of epilepsy.There is no significant difference in the expression of Cx32 between the epileptogenic lesions and the surrounding brain tissues,which may be related to the apoptosis of the neurons after multiple seizure attacks.

One hundred and seventy six consecutive patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator ( rt-PA ) in 4.5 hours from symptom onset during February 2009 to July 2013 were included in the study.Modified Rankin Scale was used to evaluate the recovery of neurological functions.Patients were divided into good ( 0 -1 ) or poor ( 2 -6 ) outcome groups according modified Rankin Scale score.Univariate analysis and multivariate logistic regression analysis were used to determine the differences of clinical data between the two groups.The age of patients with good outcome was significantly lower than that of poor outcome group [ ( 61.4 ±11.5 ) vs.( 69.0 ± 13.2) years,P =0.000].Compared to patients with poor outcomes, patients with good outcome group showed lower rate of diabetes [ 13%( 12/93 ) vs.29%( 24/83 ) , P =0.009 ] , lower blood glucose level [(5.05 ±0.97) vs.(5.83 ±1.72) mmol/L,P=0.020], higher uric acid level[(404.4 ±151.7) vs.(345.6 ±107.5) μmol/L,P=0.028],shorter onset to treatment time [(1.92 ±0.94) vs.(2.30 ±1.01) h, P=0.019],lower baseline National Institute of Health Stroke Scale score [(14.0 ±5.2) vs.(16.0 ± 6.2),P=0.025],lower systolic blood pressure level at 2 h[(140.8 ±18.3) vs.(149.0 ±18.9) mmHg (1 mmHg=0.133 kPa),P=0.005]and 24 h [(137.6 ±21.9) vs.(147.1 ±17.4) mmHg,P=0.009] after thrombolysis.Logistic regression analysis showed that uric acid levels were not related to hemorrhagic transformation independently (P =0.172,OR =0.965,95%CI:0.917 -1.016), but were related to outcome independently (P=0.047,OR=0.957,95%CI:0.916-0.999).

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.

Objective:To study the clinical effect of dynamic reconstruction of lower lip defect after squamous cell cancer resection by using unilateral Gillies fan flap and perioral muscle restoration.Methods:From Feburary 2017 to January 2020, 8 patients (6 female and 2 male, aged 55-81, 62.9 in average)diagnosed lower lip squamous cell carcinoma were accepted treatment in the Department of Otolaryngology Head & Neck Surgery, the First Affiliated Hospital of Xiamen University. All the moderate lower lip defect after cancer resection were repaired with unilateral Gillies fan flap with perioral muscle restoration under general anesthesia. The length of the vermilion of the upper lip in the Gillies fan flap was designed to be 1/3 of the length of the vermilion of the lower lip defect. The composite axial flap was prepared with the blood supply from contralateral upper lip artery-ipsilateral upper lip artery-mouth corner part of facial artery-ipsilateral lower lip artery.The end of all the perioral muscles were also prepared. After reconstruction of the continuity of the orbicularis oris, the ends of these perioral radiation muscles were restored in the position where they should be in the reconstructed lip.These perioral muscles training were undergone for 6 months after operation. After the reconstructed lip tend to be stable, measurement and calculation were carried out to evaluate the appearance, opening and closing functions of the mouth.Results:In our series of 8 cases, the length of the vermilion of the upper/lower lip was 52.4 mm(46.0-60.0 mm) in average; the circumference of the vermilion was 104.8 mm(92-120 mm)in average; the length of the defect of lower lip was 27.6 mm (21.0-35.0 mm)in average, 52.5% (42.0-67.3%) of the vermilion of lower lip. Six cases were using the right-side flap, and the other 2 cases were left. The length of the vermilion of the upper lip in the Gillies fan flap was 9.5 mm(7.0-12.0 mm)in average.All cases healed well with inconspicuous scar. No infection, hematoma or other surgical complications.No local or distant recurrence of cancer was observed during the follow-up period. Numbness of the lower lip happened posto-peration, and gradually disappeared 6 months later.Evaluation was conducted according to the measurement result preoperatively and 6 months postoperatively. (1) Appearance: the reconstructed lips were naturally symmetrical. Both side of the mouth corner were in the same horizontal level. The upper lip was lengthened with average increase of 6.8 mm and average increase rate of 15.9%. The lower lip was lengthened with average increase of 15.4 mm and average increase rate of 45.3%. In the rest situation, the circumference of the lips decreased by 5.5 mm in average compared with that preoperatively, which was 94.9% of the lip preoperatively, basically rehabilitate to the shape preoperatively.(2) Mouth-opening function: 1 week postoperation, the opening shape of mouth in all the cases was skewed with an about 1.5 fingers mouth-opening. Six months later, the opening shape of mouth was basically symmetrical round with a 3 fingers mouth-opening; in maximum mouth opening situation, the circumference of the lips decreased by 46.5 mm in average compared with that preoperatively, which was 73.1% of the lip in maximum mouth opening situation preoperatively, basically meeting physiological needs. (3) Mouth-closing function: All patient shave complete mouth-closing function and speech function.No leakage when making closed lip sound and whistling. All patients were satisfied with the oral appearance and the function of opening and closing mouth.Conclusions:Unilateral Gillies fan flap with perioral muscle restoration is a reliable method to repair the moderate full-thickness defect of the lower lip after cancer resection. After dynamic reconstruction of the perioral muscle group, the insufficient tissue of lips can be extended to obtain sufficient mouth opening, natural corner of the mouth and symmetrical lip appearance.