Objective To summarize the clinical effect and experience of vacuum sealing drainage ( VSD) technology combined with sural neurovascular flap to repair chronic and infection soft tissue defects in the foot and ankle?Methods From 2010 to 2015, the clinical effect of 58 cases patients who were treated negative pressure drainage combined with sural nerve nutrient vessel flap for repairing foot and ankle chronically infected wounds in Zhongnan Hospital of Wuhan University were retrospective analyzed?All cases were treated by debridement,negative pressure suction 1, 2 times, cleaning the wound, Wound secretions were negative after culture,then cut and take the nutrient vessels of the nutrient vessels to repair the wound?Results All flaps survived completely in 58 cases,54 cases inⅠstage healing,postoperative 4 cases were suffered with distal skin flap necrosis,and healed after dressing?The outline and function were satisfactory during 1 to 3 years follow?up?Conclusion The effect of negative pressure drainage combined with sural nerve nutrient vessel flap for repairing chronic wound of foot and ankle is exact, skin flap transposition of the wound should be thoroughly debridement,edge scar tissue should be appropriate resection.

Laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection is still difficult to accomplish,which restrains its application in total gastrectomy for advanced proximal gastric cancer.Based on our anatomical understanding of pre- and retropancreatic spaces,features of splenic vessels and distribution of perigastric lymph nodes,we combined the characteristics of laparoscopic surgery and developed a novel technique for laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection through retropancreatic space.The key lies in mobilization of the splenic pedicle through retropancreatic space,dissection of peri-vascular lymph nodes in sequence of trunk-to-branch,in-sheath vascularization of the splenic vessels.From August 2009 to December 2010,this technique was performed on 6 patients in Nanfang hospital.The initial results suggested that this technique could be safe and feasible for skillful surgeons.Further studies on the application of this technique in total gastrectomy for advanced proximal gastric cancer would be needed.

Objectives To compare the 2006 World Health Organization (WHO) growth standards and the 2005 China national growth standards for identification of the wasting, stunting, low weight and overweight in infants. Methods Data were drawn from“Infants’feeding and growth”project. Weight-for-length, weight-for-age and length-for-age were derived in z-scores using the two growth references. Stunting was defined as having a length-for-age Z-score less than-2. Low weight was defined as having a weight-for-age Z-score less than-2. Wasting was defined as having a weight-for-length Z-score less than-2. Overweight was defined as having a weight-for-length Z-score more than+2. Results Data of a total of 3909 records from 959 health children aged from 2 to 12 months from June 2008 to May 2009 were analyzed. Of them, 53.88%(2106/3909)were from male and 46.12%(1803/3909)were from female. There was no difference in wasting rate and stunting rate between using two growth references. Fewer infants were identified as low weight by using WHO growth standard than using China growth stan-dard. The results were 0.57%at 0-3 months (0.85%vs.1.42), P>0.05, 0.72%at 4-6 months (0.39%vs. 1.11%) and 0.97%at 7-9 months (0.79% vs.1.76%), P<0.05. They were equivalent at 10-12 months (1.3% vs.1.3%), P=1.00. Oppositely, more infants were identified as overweight by using WHO growth standard than using China growth standard in our study. The results were 2.9 times at 0-3 months (6.54%vs. 3.13%), 2.12 times at 4-6 months (9.02%vs.4.25%) and 1.62 times at 7-9 months (7.11%vs. 4.39%) , P<0.05. It was 1.37 times at 10-12 months(4.84%vs. 3.54%)without statistically significant difference (P>0.05). Con-clusion Some differences were found in low weight and overweight rate by using two growth standards. Infant low weight rate was lower and overweight rate was higher by using WHO growth standard than that using China growth standard.

Objective To evaluate the clinical effect of popliteal artery perforator-based sural neurovascular flap for repairing soft tissue defects in middle and distal upper leg.Methods Between December,2011 to September,2015,18 cases with skin soft tissue defects on the middle and distal upper leg were treated with popliteal artery perforator-based sural neurovascular flap,in which 12 cases were males,and 6 cases were females.The age was from 24 to 55 years,with the average age of 35.9 years.The size of tissue defects ranged from 3.0 cm × 3.0 cm to 7.0 cm × 9.0 cm.Results All flaps survived completely in 18 cases,1 case of marginal infection heated after dressing,and the rest cases in Ⅰ healing.The outline and function of survived flap were satisfactory during 3-16 months follow-up,with two-point discrimination of 4.0-10.0 mm.Conclusion The anterograde sural neurovascular flap based on the popliteal artery perforator provides a practical option for covering tissue defects in middle and distal upper leg.This flap is characteristiced by reliable blood supply without sacrificing main vesses,good contour and texture,in addition,the operation is easy of handling.

ObjectiveTo evaluate the safety and feasibility of esophagojejunostomy using transorally inserted anvil ( OrVilTM ) after laparoscopic total gastrectomy for gastric cancer.MethodsThe clinical data of 8 patients with advanced gastric cancer who were admitted to the Nanfang Hospital of Southern Medical University from January 2011 to Febuary 2012 were retrospectively analyzed.Laparoscopic total gastrectomy + D2 lymph node dissection was first performed,and then esophagojejunostomy was completed using OrVilTM. Perioperative condition and prognosis of the patients were analyzed.ResultsAll the procedures were completed successfully,with no complications occurred.There was no extension of the incisiou during operatiou.The mean operation time,anvil inserting time and volume of operative blood loss were (203 + 38 ) minutes,( 10 -+ 4) minutes and ( 106 ± 18 )ml,respectively.Tumor-free proximal margins were confirmed by pathological examination in all the patients.The mean time to first flatus,time to liquid and semi-liquid diet and duration of hospital stay were (3.5 ± 1.3 )days,(5.5 ± 2.9 ) days,( 7.5 ± 3.2) days and ( 11.5 ± 3.5 ) days.The mean time of follow-up was 10 months ( rauge,1-14 months),no anatomosis-related complications were observed.Conclusion Esophagojejunostomy using OrVilTM after laparoscopic total gastrectomy for gastric cancer is safe and feasible.

Objective:To study the association of RAC1 gene polymorphisms with protein expression levels of Rac1-GTP. Methods:A total of 182 healthy Hans population in Hubei were recruited. The 4 tag-SNPs in RAC1 gene were genotyped by Real time TaqMan-MGB genotyping assay. And the Rac1-GTP protein levels in plasma samples from all participants were determined by enzyme linked immunosorbent assays ( ELISA ) . The distribution characteristics of Rac1-GTP expression levels were also analyzed. Furthermore,the expression levels of Rac1-GTP were compared among different genotypes of the 4 tag-SNPs in RAC1 gene. Results:The distribution of Rac1-GTP expression levels was positive skewed in healthy Chinese Hans population. The expression levels were significantly higher in females than in males (P<0. 05),and appeared in decreased trend with age,but without significant differences (P>0. 05). Different expression levels of Rac1-GTP were observed in different genotypes for rs702482 and rs10951982 (P<0. 05). However,no significant difference was found for rs702483 and rs6954996 (P>0. 05). Conclusion:RAC1 genetic polymorphisms can potentially affect the expression levels of Rac1-GTP protein in healthy Chinese Hans population.

Child ; Child Health Services ; Congresses as Topic ; Education, Medical, Continuing ; Humans ; Pediatrics ; Societies, Medical ; United States

Objective To evaluate whether the reverse phase protein array (RPPA) method can be used for detecting TORCH infection in pregnant women .Methods The RPPA method was established for detecting TORCH infection .The positive coinci‐dence rates of TORCH infection detected by the RPPA method and ELISA method in 2000 fresh serum samples from pregnant women were compared for evaluating the feasibility of RPPA in TORCH detection .Results The positive coincidence rates of estab‐lished RPPA and ELISA for detecting TORCH infection was 100 .0% ,91 .1% ,97 .2% ,91 .3% and 93 .0% respectively ,indicating that the detection results of various indexes by RPPA and ELISA had better consistency (P>0 .05) ,but the positive detection rates of RPPA for Rubellavirus ,CMV and HSV‐1 ,2 were higher than those of correspondent ELISA method .Conclusion RPPA method for detecting TORCH infection has the advantages of simpleness ,rapidness ,high sensitivity and strong specificity ,is an effective method of auxiliary diagnosis for bearing and rearing better children in clinical ,and is worthy of being promoted and used in the fu‐ture .

Objective To investigate the clinical and laboratory characteristics of patients with chronic lymphocytic leukemia (CLL). Methods 503 patients with CLL admitted from October 1998 to February 2015 were retrospectively analyzed. Baseline characteristics were compared using Chi-square test and Kaplan-Meier methodology was undertaken for survival analyses. Results The median age was 58 years (26-86 years):335 cases were male and 168 cases were female. 204 cases (40.5%) were at the clinical stage of Binet A, followed by Binet B (148 cases, 30.1%) and Binet C (151 cases, 29.3%). 108 cases (21.1%) had anemia at diagnosis, while 113 cases (26.5 %) had an elevated level of lactate dehydrogenase and the expression of CD38 was detected among 100 cases (29.1 %). Clonal abnormalities were observed using fluorescence in situ hybridization (FISH) analysis. Those involving 13q deletion were the most frequent (156 cases, 47.3 %), followed by IgH translocation (22.4 %), trisomy 12 (21.2 %) and 17p deletion (14.5 %). The mutational status of immunoglobulin heavy chain variable region was determined among 230 cases, 165 cases (71.7%) of which were found to be with mutated status. The most frequently encountered gene was V4-34 (28 cases, 12.4 %). The median progression-free survival (PFS) was 89.0 months (95 %CI 75.0-103.0 months), while the median overall survival was 129.0 months (95 %CI 106.9-151.1 months). Conclusion Compared with patients in the western world, CLL patients in this study are younger at diagnosis and have longer overall survival, which, to some extent, could reflects the characteristics of CLL patients in China.

OBJECTIVETo investigate the safety and efficacy of postoperative intraperitoneal hyperthermic perfusion chemotherapy(IHPEC) following laparoscopic palliative resection for advanced gastric cancer patients with peritoneal metastasis.

METHODSBetween March 2010 and October 2013, 37 patients with advanced gastric cancer were treated by IHPEC(cisplatin 100 mg, 5-fluorouracil 1000 mg and saline 2000 mL) following laparoscopic palliative resection in our department between March 2010 and October 2013 were analyzed retrospectively. Short-term efficacy and adverse reactions were observed.

RESULTSComplete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD) were found in 18, 4, 8 and 7 cases respectively, and the total progression-free rate was 59.5%(22/37). The significant improved, improved, stable and progressive cases of Karnofsky performance status were 6, 13, 10 and 8 respectively, and the rate of improved and stable cases was 78.4% (29/37). Serious adverse reactions (class III ( or IIII) were noted in 3 cases (8.1%), including 2 cases of abdominal pain (class III), 1 case of nausea and vomiting.

CONCLUSIONSThe modality of IHPEC adopting cisplatin plus 5-fluorouracil regimen following laparoscopic palliative resection for advanced gastric cancer patients with peritoneal metastasis is technically feasible and safe, which has certain effect on postponing the progression of gastric cancer.

Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Cisplatin ; Fluorouracil ; Humans ; Laparoscopy ; Palliative Care ; Peritoneal Neoplasms ; drug therapy ; secondary ; surgery ; Remission Induction ; Retrospective Studies ; Stomach Neoplasms ; drug therapy ; surgery