Objective To develop a method to determine the content of ketoconazole in the disinfectant by HPLC. Methods The separation was carried out on an ODS C18 column. Methanol-water (80+20) was used as the mobile phases. The flow rate was 1.00 ml/min, the detection wavelength was 239 nm. Results The linearity was obtained in the range of 1.00-100 ?g/ml for ketoconazole, the average recovery rates were 98.1%-99.8%. The difference in a day and in another day was less than 2%. The detection limit was 1.08 ?g/ml. Conclusion This method is simple, accurate, rapid and can be used as a quantitative analysis method for ketoconazole.

The incidence of esophagogastric junction cancer (EGJC) is rising dramatically both in western countries and in China.For type Ⅱ EGJC,controversies over the optimal surgical approach still remain.More and more studies support the abdominal transhiatial extended gastrectomy to be superior to the abdominothoracic combined approach.The aim of this report is to evaluate the feasibility and safety of laparoscopic transabdominal hiatal extended gastrectomy for surgical treatment of type Ⅱ and Ⅲ esophagogastric junction cancer.Based on clinical experience of 95 patients who underwent laparoscopic tansabdominal hiatal extended gastrectomy,we conclude that laparoscopic transabdominal hiatal extended gastrectomy is feasible and safe,offering a safer and simpler way of intramediastinal dissection and digestive tract reconstruction at experienced hands as compared with open surgery.This procedure also offers the merit of longer esophageal resection length without entering the pleural cavity.

Objective To study the methods and clinical effects of joint expansion of double fascia flaps wrapping the Medpor to perform full-ear reconstruction on congenital microtia deformity.Methods 60 patients with congenital microtia deformity were selected.including 22 left ears and 38 right ears.Majority had loss of ear auricle or only partial earlobe.Phase Ⅰ procedures included:temporal-parietal branch was used for the vascular pedicle,and mastoid area behind the ear was moved and expanded for fascia flap.Phase Ⅱ included:the joint expansion of double fascia flap wrapped Medpor to do full-ear reconstruction.Results Flaps survived and no complications for all 60 patients.Reconstructed ears had lifelike appearance and clear anatomical structures.Auriculocephalic angulars positions and sizes were consistent with the healthy ears.None of them had exposed prosthesis and scar contraction.Three-dimensional shapes were good.Conclusions Joint expansion of double fascia flap wrapping Medpor could avoid the chest wall deformity and exposed prosthesis.The fine structure of the reconstructed ear is satisfactory.

Objective To study the methodology and results of the auricle repair with expanded skin flap in mastoid process area and Medpor support in children with congenital malformation.Methods Thirty cases of congenital malformation were enrolled with age ranged from 5～16 years old.Whole auricles were all reconstructed with an expanded skin flap in mastoid process area and Medpor support.Resuits In all successful cases.their repaired auricles had the natural complexion and profile,and the positions were symmetric with healthy one,but in 2 cases(age group of 11-16 years),the expanded skin flap had less skin grafting.Conclusion It is suggested that optional operation time might be selected before 10 years old,because their psychological trauma could be avoided owing to microtia and in that age the size of the expanded flap is larger enough to reconstruct the ear as their auricle iS well-developed.

Objective To discuss the correction of lower baggy eyelid with severe tear trough and eyelid sulcus (groove deformity) and its therapeutic effect.Methods Through incision at the lower eyelid margin,the dissection was performed at the deep surface of the orbicularis muscle to expose the orbital septum and inferior orbital rim periosteum.The orbital fat which was released from orbital septum was repositioned at the inferior orbital rim and fixed on periosteum.If the depression was not completely corrected,the extra orbicularis fixed with periosteum.If the depression was not completely corrected,the extra orbicularis muscle was designed as muscle flap with interior pedicle to further correct the groove deformity.Results 60 cases were treated with no depression or unsmooth deformity.All the cases were followed up for 3-12 months with satisfactory aesthetic effect.Conclusions Orbicularis flap combined with orbital fat reposition is a simple and effective method for correction of tear trough and eyelid sulcus deformity.

Objective To study the effect of five combined operation for anus reconstruction after Miles operation in patients with lower colorectal cancer.Methods 60 patients with lower colorectal cancers received Miles operation,followed by five combined operation for anus reconstruction (internal and external anal sphincter,rectal flap,rectal angle,anus perineal reconstruction).Results 5-6 days after operation,all cases had desire to excretion.2-3 weeks lateral,all cases desired to control excretion and excreted 1 or 2 times per-day.Internal rectum testing showed the static pressure in anus,the constrictive pressure,and the static pressure in rectum were all normal.The survival rate of patients over 5 years was beyond 88％.Conclusions It suggests that five combined operation for anus reconstruction after Miles operation could avoid man-made anus on abdomen.It can improve the patients' life quality,long-term survival rate.And it's also economical method for patients.

Objective To discuss the correction of lower baggy eyelid with severe tear trough and eyelid sulcus (groove deformity) and its therapeutic effect.Methods Through incision at the lower eyelid margin,the dissection was performed at the deep surface of the orbicularis muscle to expose the orbital septum and inferior orbital rim periosteum.The orbital fat which was released from orbital septum was repositioned at the inferior orbital rim and fixed on periosteum.If the depression was not completely corrected,the extra orbicularis fixed with periosteum.If the depression was not completely corrected,the extra orbicularis muscle was designed as muscle flap with interior pedicle to further correct the groove deformity.Results 60 cases were treated with no depression or unsmooth deformity.All the cases were followed up for 3-12 months with satisfactory aesthetic effect.Conclusions Orbicularis flap combined with orbital fat reposition is a simple and effective method for correction of tear trough and eyelid sulcus deformity.

Objective To study the effect of five combined operation for anus reconstruction after Miles operation in patients with lower colorectal cancer.Methods 60 patients with lower colorectal cancers received Miles operation,followed by five combined operation for anus reconstruction (internal and external anal sphincter,rectal flap,rectal angle,anus perineal reconstruction).Results 5-6 days after operation,all cases had desire to excretion.2-3 weeks lateral,all cases desired to control excretion and excreted 1 or 2 times per-day.Internal rectum testing showed the static pressure in anus,the constrictive pressure,and the static pressure in rectum were all normal.The survival rate of patients over 5 years was beyond 88％.Conclusions It suggests that five combined operation for anus reconstruction after Miles operation could avoid man-made anus on abdomen.It can improve the patients' life quality,long-term survival rate.And it's also economical method for patients.

Objective:To explore the value of fast susceptibility weighted imaging (SWI) generated by a deep learning model in assessment of acute ischemic stroke (AIS).Methods:From January 2019 to January 2021, 118 AIS patients [75 males and 43 females, aged 23-100 (66±14) years] who underwent MR examination and SWI sequence scanning within 24 h of symptom onset in the First Medical Center of PLA General Hospital were retrospectively analyzed. MATLAB ′s randperm function was used to divide 118 patients into a training set of 96 cases and a test set of 22 cases at a ratio of 8∶2. Fourty-seven AIS patients [38 males and 9 females, aged 16-75 (58±12) years] from one center of a multicenter study were selected to build the external validation set. SWI image and filtered phase image were combined into complex value image as full sampling reference image. Undersampled SWI images were obtained by retrospective undersampling of reference fully sampled images, and the undersampling multiple was five times which could save 80% of the scanning time, then the complex-valued convolutional neural network (ComplexNet) was used to develop reconstruct fast SWI. Interclass correlation coefficient (ICC) or Kappa tests were used to compare the consistency of image quality and the diagnostic consistency for the presence of susceptibility vessel sign (SVS), cerebral microbleeds and asymmetry of cerebral deep medullary veins (DMVs) in AIS patient on fully sampled SWI and fast SWI based on ComplexNet.Results:In test set, score of image quality was 4.5±0.6 for fully sampled SWI image and 4.6±0.7 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.86, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.79, P<0.05), microbleeds (Kappa=0.86, P<0.05), and DMVs asymmetry (Kappa=0.82, P<0.05) in AIS patients. In the external validation set, score of image quality was 4.1±1.0 for fully sampled SWI image and 4.0±0.9 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.97, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.74, P<0.05), microbleeds (Kappa=0.83, P<0.05), and DMVs asymmetry (Kappa=0.74, P<0.05) in AIS patients. Conclusions:Deep learning techniques can significantly accelerate the speed of SWI, and the consistency of image quality and detected AIS signs between fast SWI based on ComplexNet and fully sampled SWI is good. The fast SWI based on ComplexNet can be applied to the radiographic assessment of clinical AIS patients

Objective:To investigate the relationship between the cerebral small vascular disease (CSVD) total burden and the imaging markers and the degree of unilateral middle cerebral artery (MCA) stenosis.Methods:The study was a cross-sectional study. Clinical and imaging data of patients with chronic unilateral MCA stenosis who underwent multimodal MRI from October 2015 to January 2019 in the First Medical Center of PLA General Hospital were retrospectively analyzed. A total of 261 patients were included, 187 males and 74 females. According to the degree of MCA stenosis, the patients were divided into 102 cases in severe stenosis-occlusion group (stenosis degree ≥70%) and 159 cases in mild-moderate stenosis group (stenosis degree <70%). CSVD imaging marker scores (including white matter hyperintensity, perivascular space, cerebral microbleed, and lacune of presumed vascular origin) were assessed according to the ?standards for reporting vascular changes on neuroimaging 1 in the 2 groups, and the CSVD total burden score was calculated. Mann-Whitney U test was used to compare the indicators between the two groups, and the CSVD total burden score and imaging marker scores were ultimately included in a multifactorial binary logistic regression to assess the association of CSVD imaging markers with severe stenosis-occlusion of the MCA after adjusting for vascular risk factors (age, gender, drinking, smoking, hypertension, hyperlipidemia, atrial fibrillation and coronary heart disease). Results:There were significant differences in the CSVD total burden, centrum semiovale perivascular space and lacune of presumed vascular origin score between the mild-to-moderate stenosis group and the severe stenosis-occlusion group (all P<0.05), and none of the differences in the remaining imaging marker scores were statistically significant (all P>0.05). Multivariate binary logistics regression analysis showed CSVD total burden score ( OR=1.300, 95% CI 1.047-1.613, P=0.017), centrum semiovale perivascular space score ( OR=2.099, 95% CI 1.540-2.860, P<0.001) and lacune of presumed vascular origin score ( OR=2.609, 95% CI 1.294-5.261, P=0.007) were independent associated with severe stenosis-occlusion of MCA. Conclusion:The higher CSVD total burden score, centrum semiovale perivascular space score and lacune of presumed vascular origin score are associated with severe stenosis-occlusion of MCA.