Objective To study the effects of a self-controlled and totally-enclosed type perfusion skin and tissue expansion in which pressure was continuous and constant. Methods Totally-enclosed type perfusion system included single-used infusion apparatus, triplet, soft water storage bag, catheter, and common expander. Continuous pressure-constant system included inflatable infusion apparatus and common spring sphygmomanometer. Expander was filled from soft water storage bag which was put in inflatable infusion apparatus by crushed ball. The pressure of expander was controlled by patients according to pain threshold. 26 expanders were used in 20 patients in clinical practice. The volume of expander was about 100 ~ 400 ml. After 3~5 days from operation, water began to fill in the expander and stopped when the expansion area reached. Results The volume of expander was 120~640 ml and the duration of expansion was 10~16 days, average (13.6? 2.1) days, without any complication. Conclusions The tissue expansion with continuous and constant pressure and totally-enclosed perfusion is worth popularizing because of its easy preparation, simply operation, rapid expansion, safety and comfort.

Objective:To explore the molecular mechanism of Wendan Decoction in the treatment of Hypertension by the network pharmacolog. Methods:The potential active components and targets of Wendan Decoction were screened in TCMSP and TCMIP database. The TTD, genecards and OMIM databases were used to collect hypertension targets. Then the protein interaction was analyzed by using String database. The software of Cytoscape v3.7.1 was used to construct the network diagram of Wendan Decoction in the treatment of Hypertension and using the software of ClueGO to analyze GeneOntology and KEGG pathway of the potential targets. Finally, we used molecular docking technology for the appropriate of molecules and targets. Results:A total of 141 potential active components and 108 potential therapeutic targets were selected from Wendan Decoction. And 20 of core targets selected by MCC in CytoHubba. The GeneOntology analysis contained 164 GO terms, 133 of biological processes, 24 of molecular functions, and 7 of cell components. Seven key pathways were selected by enrichment analysis of KEGG pathway. Molecular docking results showed good docking between key components and targets.Conclusion:Wendan Decoction can treat hypertension through multiple ways and targets. This study predicts the possible mechanism of Wendan Decoction and provides data for its clinical application.

OBJECTIVE: To investigate the therapeutic mechanism of tetromethylpyrazine and aminoguanidine on diabetic nephropathy. METHODS: Diabetic rats were induced by streptozotocin. They were divided into 5 groups: normal control group (group C), untreated diabetic group (group DM), tetromethylpyrazine treated group (group TMP), aminoguanidine treated group (group AG) and tetromethylpyrazine and aminoguanidine treated group (group TMP+AG). The expression of vascular endothelial growth factor (VEGF) in renal cortex of the rats in each group was observed by immunohistochemical staining after 12 weeks. RESULTS: The expression of VEGF in renal cortex of the rats in group TMP+AG and group C was alike. The expression of VEGF in renal cortex of group TMP and group AG decreased significantly as compared with that of group C, but was still above normal level. CONCLUSION: The therapeutic mechanism of tetromethylpyrazine and aminoguanidine on diabetic nephropathy may be inhibiting the over-expression of VEGF in kidney of diabetic rats.

Objective To investigate the clinicopathological characteristics, diagnosis and treatment of huge adrenal tumor.Methods Retrospectively analysed the clinical data of the 2 patients with huge adrenal tumor more than 10 cm in diameter, who were admitted in our hospital from September 2013 to January 2015.Clinical manifestations, treatment and prognosis were evaluated.Results Two patients were both suspected of adrenocortical carcinomas.Case 1 was a 28-year-old female.Laparoscopic surgery was performed at first but was conversed to open palliative adrenalectomy due to tumor rupture and bleeding.The postoperative pathology was adrenocortical carcinoma.The patient died of gastrointestinal bleeding caused by tumor metastasis 10 months later.Case 2 was a 39-year-old female, who underwent laparoscopic adrenolectomy with tumor excision completely.The postoperative pathology showed neoplasm of malignant potential, and no tumor recurred in 15 months follow-up.ConclusionsOpen surgery should be the priority if the diameter of adrenal tumor is more than 10 cm and diagnosis as suspicious of malignancy.Huge adrenocortical carcinoma is related to poor therapeutic response,and multimodality therapy may improve the prognosis.

Objective: To investigate the development of osteoporosis (OS) and its influencing factors among physical examination populations aged over 35 years in urban areas of Hangzhou City, so as to provide insights into OP prevention. Methods: Subjects aged over 35 years that underwent physical examinations in Wenhui Street Community Health Service Center of Gongshu District, Hanghzhou City during the period between April and July, 2022 were enrolled. Subjects' demographic characteristics and physical examination data were collected, and the bone mineral density and serum vitamin D levels were measured. The factors affecting the development of OP were identified using a logistic regression model. Results: A total of 1 561 subjects were recruited, including 616 males (39.46%) with a median (interquartile range) age of 62 (18) years, and 945 females (60.54%) with a median (interquartile range) age of 62 (19) years. The prevalence of OP was 43.69% among the study subjects. Multivariable logistic regression analysis identified women (OR=1.367, 95%CI: 1.105-2.979) and increased age (OR=1.057, 95%CI: 1.044-1.069) as risk factors for OP and elevated serum 25-hydroxy-vitamin D levels as a protective factor for OP (OR=0.969, 95%CI: 0.954-0.985). Conclusions The prevalence of OP was 43.69% among physical examination populations aged over 35 years in urban areas of Hangzhou City, and gender, age and serum 25-hydroxy-vitamin D were factors affecting the development of OP.

OBJECTIVE: To discuss the application of frontal sinus optical probe in endoscopic frontal sinus surgery. METHOD: The clinical data of 58 adult patients (86 sides) suffering from chronic frontal sinusitis were analyzed retrospectively. The patients received endoscopic frontal sinus surgery with frontal sinus optical probe because of difficulty in confirming ostia under endoscope. All cases were followed up post operation to evaluate the efficacy. RESULT: The ostia of frontal sinus were successfully opened with this method in all cases, and no serious intracranial or orbital complication occurred. After 6 to 18 months follow-up postoperatively, the symptoms vanished in 51 cases and improved in 7 cases and none of all recurred. The endoscopic examinations showed well opening of frontal sinus ostia. CONCLUSION Localization of frontal ostium with frontal sinus optical probe is a simple, convenient, safe and effective accessorial method for revision endoscopic frontal sinus surgery.
Adult ; Aged ; Endoscopy ; methods ; Female ; Follow-Up Studies ; Frontal Sinus ; surgery ; Frontal Sinusitis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies

Purpose To study the clinical features,pathological manifestation and immunohistochemical phenotype and improve the diagnosis and treatment of myoepithelial carcinoma in salivary glands.Methods Histomorphology and immunohistochemical phenotype were analyzed after the sections were stained with routine HE and immunohistochemical methods,and the relevant literatures were reviewed.Results The tumours were predominantly composed of pale-stained clear cells.In some cases,plasma-like cells,epithelioid cells and spindle cells were also seen.The cells were arranged in nest,solid or cords.Mitosis was easily seen,cytological atypia was obvious and necrosis existed in 4 cases.The results of immunohistochemical staining showed that CK was expressed in all cases.EMA was expressed in 8 cases.p63 and CK5/6 were expressed in 11 cases.S-100 was expressed in 10 cases.vimentin was expressed in 4 cases.Calponin was expressed in 2 cases.SMA was expressed in one case.The proliferation index of Ki-67 was 5％ to 40％.Conclusion The histological changes of myoepithelial carcinoma cells are diverse,and pathological and immunohistochemical methods are helpful for improving the rate of right diagnosis.Sugery is the main treatment for myoepithelial carcinoma.

Objective To study the clinical manifestation, pathological character, treatment strategies and prognostic factors of phyllodes tumor of breast .Methods We retrospectively reviewed 41 patients with breast phyllodes tumor.Results The average age was 35. Among all the patients, there were 20 benign cases, 5 borderline cases, 16 malignant cases. 19 patients received extensive local excision, 7 patients received local excision, 9 patients received simple mastectomy of breast and 6 patients were treated with modified radical operation. There were 4 patients undergoing radiotherapy after the operation. Follow-up was obtained for 35 cases, with an average of 26 months (5~101 months), one of the patients died of metastasis 3 years after the operation, two patients suffered from local recurrence.Conclusions Appropriate operation is the most important prognostic factor of breast phyllodes tumor.

Objecive To explore the significance of RECK expression in breast cancer .Methods Im-munohistochemical staining was used to analyze RECK expression levels in patients with breast cancer .We com-pared these data with the clinicopathological features of these patients .Rseults Breast cancer patients with nega-tive RECK expression had significantly lower DFS and 5-year survival rates than patients with positive RECK expression.In addition,for node-negative breast cancer ,negative RECK expression indicated markedly unfavor -able survival rate than positive arm .Multivariate analysis further confirmed that RECK expression was an inde -pendent prognostic factor for patients with breast cancer .Conclusion The loss of RECK expression indicates un-favorable survival rate for patients with breast cancer .RECK expression is a new ,important risk factor for recur-rence in breast cancer .

OBJECTIVE To explore the advantage of exposure recurrent laryngeal nerve in thyroidectomy. METHODS Exposure the recurrent laryngeal nerve was performed deliberately in 452 cases during thyroidectomy. The larynx was examined with laryngoscope before and after operation. RESULTS Of the 452 cases with 748 exposed recurrent laryngeal nerve, only 14 cases (1.88%) occurred temporary recurrent laryngeal nerve palsy, and 2 cases (0.27%) occurred permanent recurrent laryngeal nerve palsy. CONCLUSION Exposure the recurrent laryngeal nerve during thyroidectomy can protect the nerve from surgery injury.