Objective To analyze the efficacy of repairing unilateral cleft lip (UCL) with Millard method, and explore the individual operative procedure. Methods According to the difference of lip height between non-cleft and cleft sides, MillardⅠ, MillardⅡ or modified Millard Ⅱ operative approach was chosen to repair UCL, then the clinical effect of operation was evaluated. Results The ideal operative effects were obtained in 208 cases of UCL using various operative approaches based on the individual deformity. There were consistent lip height between both sides, normal vermillion bulk and satisfactory facial appearance after operation. Conclusion The satisfactory efficacy could be obtained by choosing Millard method's operative approaches based on the individual deformity. The modified Millard operative approach could repair all kinds of UCL.

Objective To discuss the preventive measures of anterior palatal fistula by modified the operation of cleft palate. Methods For 23 patients of complete cleft palate with alveolar ridge cleft, bilateral mucoperiosteum flap was moved forward as possible so as to close fistula front of hard palate, and incised junction of the hard and soft palate to prolong soft palate and the wound was repaired by buccal mucosal flap.The incidence of anterior palatal fistula and velopharyngeal closure after operation was observed. Results Twenty-three patients were rechecked 1 month after operation ,there was no anterior palatal fistula occurring,10 cases were examined by epipharyngoscope 1 year after operation,the velopharyngeal closure was 90%-100%. Six cases were followed up for 6 months,the velopharyngeal closure was 80%-85%. Conclusions For second-stage operation methods of anterior palatal fistula, there are too many discussions of selection criterias, advantages and disadvantages. If first-stage operation is taken measures to prevent anterior palatal fistula or decrease the diameter of fistula as possible. It reduces percentage of second-stage operation or decreases the difficulty. It should get more attention in the clinical works.

Objective To establish a new flow-injection chemiluminescence(CL) method for the determination of hydrocortisone.Methods In H2SO4 solution,hydrocortisone could obviously enhance the chemiluminescence intensity of the reaction of KMnO4-Na2SO3 system.Based on this,a new flow-injection CL method for the determination of hydrocortisone was developed.Results There was a good linear relationship between CL intensity and the concentration of hydrocortisone in the range of 1.0?10-9-1.0?10-6g/mL.The detection limit was 4.0?10-10g/mL at a signal-to-noise ratio of 3∶1.The RSD of 11 assays was 2.2%.Conclusion This method can be successfully used to determine the quantity of hydrocortisone in injection.It is rapid,accurate,simple,and has high sensitivity and wide linear range.

Objective: To investigate the molecular typing and drug resistance of Salmonella in market-sold raw livestock meats in Shaoxing City, Zhejiang Province, so as to provide the basis for the prevention and control of drug-resistant Salmonella. Methods: Salmonella isolates were detected and serotyped from raw livestock meat samples collected from supermarkets, agricultural markets and restaurants in Shaoxing City between March and November 2023. Molecular typing was performed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Antibiotic resistance phenotypes and resistance gene analyses were conducted using broth microdilution method and whole genome sequencing. Results: A total of 34 Salmonella isolates were detected from 329 samples and the positive rate was 10.33%. There were 14 serotypes, with S. Rissen (9 isolates, 26.47%) and S. London (8 isolates, 23.53%) being dominant. PFGE typing revealed 31 band patterns and 23 banding pattern clusters of Salmonella, and the similarity ranged from 30.80% to 100.00%, without dominant band patterns. MLST identified 15 sequence typing (ST) types, and S. Rissen were all ST469 and S. London were all ST155. Salmonella strains exhibited high levels of resistance to tetracycline (44.12%) and ampicillin (35.29%). Thirteen resistance patterns were identified, with 8 multidrug resistant patterns (29.41%). There were 8 classes of 14 resistance genes, with aminoglycoside resistance gene aac(6' )-Iaa found in 100.00% of the strains. The highest concordance rate between the resistance phenotype and gene was observed for phenicol antibiotics (97.06%), while there was no concordance between the quinolone resistance phenotype and genes. Conclusions S. Rissen and S. London are the predominant serotypes in market-sold raw livestock meats in Shaoxing City. The PFGE band types of the Salmonella isolates show polymorphism distribution, and MLST are mainly ST469 and ST155. The isolates have high levels of resistance to tetracycline and ampicillin, manifesting multidrug resistance.

Objective To observe the pathological changes of tissues of the injured bile duct, and to provide theoretical basis for bile duct repair. Methods Dog models of obstructive biliary injury were established.Sixty dogs were equally divided into five groups according to the duration of biliary obstruction: biliary obstruction for 5 days (BDL5 group), 10 days (BDL10 group), 15 days (BDL15 group), 20 days (BDL20 group) and 30 days (BDL30 group). The morphological and pathological changes of bile duct and local tissues were observed, and biliary-enteric Roux-en-Y anastomosis was applied to repair the injured bile duct and postoperative complications were observed. All data were analyzed by LSD test, independent sample t test, one-way analysis of variance and chi-square test. Results Proximal bile duct rapidly expanded as the pressure increased in the early stage, and the bile duct expanded to ( 15.6 ± 1.8)mm in the BDL10 group. The expansion rate decreased in the later stage,and the bile duct expanded to (18.9 ± 1.9)mm in the B DL15 group. Acute inflammation was observed in injured local tissues. The acute inflammation was severe in the BDL5 group with white blood cell count of 54 ± 6, and the acute inflammation was relatively mild in the BDL15 group with white blood cell count of 42 ± 7. There was a significant difference between the BDL5 group and BDL15 group in the degree of acute inflammation (t =4. 688,P ＜ 0. 05). The content of the collagen was increased in the injured bile duct as time passed by. Bile duct repair was successfully performed on 57 dogs. Ten dogs ( three in the BDL5 group, four in the BDL10 group, one in the BDL15 group, one in the BDL20 group and one in the BDL30 group) died of bile leakage after the operation. The incidences of bile leakage was 30% (7/23) within 10 days and 9% (3/34) beyond 10 days, with a significant difference between the two groups (x2 =4.429, P＜0.05). Conclusion Ten days after obstructive biliary injury,an obvious reduction of bile duct expansion and edema of the bile duct is observed, the difficulty of the operation is reduced and the incidence of bile leakage is low, so 10 days after the incidence of obstructive biliary injury is the proper timing for the surgical repair.

ObjectiveTo study preoperative diagnosis and operative route of traumatic diaphragmatic rupture in order to improve postoperative quality of patients' life.MethodsA retrospective analysis was carried out in 63 patients with traumatic diaphragmatic rupture,all that were identified through operation from January 1990 to March 2009.All cases were associated with pneumothorax and/or hemopneumothorax at various degrees.Forty-nine cases complicated with acute peritonitis and 41 cases complicated with hemorrhagic shock.Thirty-seven cases were diagnosed definitely preoperatively,22 cases were found in operations research,4 cases with inefficacious conservation converted to operation.Thoracotomy was performedin 24 cases,laparotomy in 14 cases,combined thoracolaparotomy in 8 cases and thoracotomy plus laparotomy in 17 cases.ResultsFifty-seven cases recovered,6 cases died of hemorrhagic shock (2 cases),pericardial tamponade ( 1 case),acute respiratory failure ( 1 case) and acute renal failure at postoperative 1 week (2 cases).ConclusionDefinite and timely preoperative diagnosis and correct operative approach are striving the rescue time and success and avoiding complication.

Objective To explore the influence of different method of mediastinal lymph node excision on the immune function of non-small cell lung cancer patients.Metbods Clinical data was collected continuously from 415 cases of inhospital patients with non-small cell lung cancer from March 2009 to March 2012,who were divided into system lymph node dissection group (SLND,216 cases) and lymph node sampling group (LNS,199 cases).The total lymphocytes,NK cells,CD4+ T cells and CD8+ T cells in blood samples taken preoperatively and at 3rd and 7th day postoperation were analyzed.Results Total lymphocytes,NK cells and CD8+ T cells were reduced significantly in the SLND group compared with those in LNS group at 3rd day and 7th day postoperation (3rd day:LC (0.95±0.57) × 109/L vs (1.10±0.65) × 109/L,CD8+ T cells (19.53± 6.48) ％ vs (20.93±6.70) ％,NK (17.36±6.06) ％ vs (18.57±5.97) ％,P ＜ 0.05; 7th day:LC (0.86±0.53) × 109/L vs (1.00±0.60) × 109/L,CD8+ T cells (17.27±5.64) ％ vs (18.40±5.26) ％,NK (13.11±4.84) ％ vs (14.20± 5.30) ％; P ＜ 0.05).CD4+ T cells in the SLND group were reduced significantly at 3rd day postoperation compared with LNS group ((29.59±6.53) ％ vs (31.19±6.32) ％,P ＜ 0.05).Conclusion LNS can reduce immunosuppression compared with SLND for postoperative patients.

This study retrospectively reviewed 9 cases of complicated hepatic cystic hydatidosis with intrabiliary rupture who were surgically treated with pericystectomy in combination with Roux-en-Y hepaticojejunostomy in our hospital from 2004 to 2010. The clinical features, results of laboratory tests, B-mode ultrasonography and CT, post-operative recovery, days of hospital stay after the operation and post-operative complications were statistically analyzed and the patients were followed up. The subjects in our series included 7 males and 2 females, whose average age was 50.78±7.58 years. Before operation, 9 patients suffered from pain of the right upper quadrant and jaundice, which, in 4 cases (44.45%), were accompanied with fever and chills. Preoperative B-mode ultrosonography and CT showed that all the 9 patients had single hydatid cyst, with their diameter being 9.33±1.58 cm on average. The lesions involved segments V, VI in 6 cases, and segment IV in 3 cases. By WHO classification, 7 cases were classified as CE3 and 2 cases as CE4. They all had choledochectasia. The subjects underwent the surgery uneventfully. Intraoperatively, 2-4 biliary fistula orifices were found, with the average of the orifice being (0.79±0.20) cm. After the operation, one patient developed incision infection, one had pulmonary infection and one suffered from reflux cholangitis. No anastomotic leaks or peri-operative deaths took place and follow-up revealed no recurrence and implantative metastasis. We are led to conclude that pericystectomy in combination with Roux-en-Y hepaticojejunostomy can achieve satisfactory results for the treatment of complicated hepatic cystic hydatidosis with intrabiliary rupture.

Objective To investigate the relationship between abnormal methylation in promoter regions for OPN and VSMC phenotype switching in varicosity.Methods Immunohistochemistry and Western-blot were used to evaluate the expression of SMA and OPN in VSMC.Methylation-specific PCR was used to evaluate the methylation level of OPN in VSMC of vein samples.Ultrastructure change of VSMC was observed by transmission electron microscope (TEM).Results Compared to normal vein,OPN in VSMCs were significantly highly expressed,mainly in the neointimal region (P ＜ 0.01).SMA in neointima region was in low expression (P ＜ 0.01).The density of OPN in varicose group was significantly higher (P ＜0.01).DNA methylation level of OPN was lower in varicose veins.Conclusions Hypomethylation of the promoter regions for OPN may cause high expression of OPN leading to VSMC phenotype switching and development of varicosity.

Objective To observe effect of lidocaine pretreatment to malondialdehyde(MDA) and endothelin(ET) of patient ac-cepeted brain tumor removing and discuss the optimized pretreatment time .Methods 60 brain tumor patients in the hospital from March 2009 to September 2011 .according to the different pretreatment time ,the patients were randomly divided into five groups :group A(preoperative 48 h) ,group B(preoperative 24 h) ,group C(preoperative 12 h) ,group D(0 h or anesthesia induced) ,group E (control group) and group F(blank control group) ,10 cases in each group .Group A ,B ,C ,D with 1% lidocaine 1 .5 mg/kg intrave-nous pretreatment on schedule ,then induced conventional anesthesia ;group E were supplemented with 1% lidocaine 2 .5 mg · kg -1 · h-1 intravenous injection after anesthesia induction ;group F was performed routine program without lidocaine .The spontaneous breathing time ,awake time and tracheal extubation time was recorded ,while NIHSS score for evaluation of neural function defect was applied ,and peripheral serum level of MDA and ET was detected by colorimetric technique and radio-immunity .Results In group C ,the spontaneous breathing time ,awake time and tracheal extubation time were shorter than other groups ,but the difference had no statistically significant(P>0 .05) .There was no significant difference among each group in the aspect of NIHSS score 1 day before surgery(P>0 .05) ,after 14 days of operation ,NIHSS of group C was statistically lower than that of group E and group F (P<0 .05) .Before anesthesia induction ,there was no significant difference among groups (P> 0 .05) .MDA and ET content in group C was significantly lower than those in other groups after surgery (P<0 .05) .Conclusion Lidocaine given 12 h before cere-bral ischemia has varying degree protection against cerebral ischemia-reperfusion injury .The protection has relation with the de-crease of MDA and ET content .