Objective To investigate the methods and effects of nasolabial flaps for repair of defects after skin tumor removal on midface.Methods From Augest 2012 to March 2015,the different flaps from nasolabial fold were utilized to repair 22 skin defects due to surgical removal of skin tumors on midface.There were 12 flaps with subcutaneous pedicle and 10 flaps with skin pedicle in the group.The size of the defects ranged from0.5cm × 1.0cmto4.0cm × 5.0cm.Results After operation,all flaps survived with primary healing,cosmetic results were satisfactory with conceal scar and no facial organs distortion after 1 month to 2 years following-up.No tumor recurrence occurred.Conclusions Thenasolabial flaps with appropriate pedicles could obtain the satisfactory results for the reconstruction of medium-sized skin defects on midface,especially suitable for middle-aged and elderly patients.

Objective To evaluate the prognostic value of intraoperalive detection in rib bone marrow micmmetastasis(BMMs)of patients with non-small-cell lung cancer(NSCLC)and the relationship between the micROmetast ases and clinicopathologic factors.Method From April 2004 to May 2007,146 patients undergoing surgical treatment for NSCLC were prospectively investigated for the presence of BMMs by the immunohistochemisury method.Remits 30.82%(45/146)of NSCLC patients were detected with BMMs,15(33.33%)patients developed remote metastases of the 45 patients with BMMs,14(13.86%)patients developed metastases of the 101 patients without BMMs.Patients with BMMs demonstrated an earlier metastasis and a lower survival rate compared with patients without BMMs(P＜0.05).There Was trend for ahigher frequency and the occurrence of BMMs changed with tumor stages and the histologic differentiation of the tumor.No relationship was found between BMMs and age,T grade,as well as tumor dimension.Conclusions The detection of BMMs can predict the prognosis of NSCLC patients and identifies patients withNSCLC who are at significantly increased risk for metastasis and survival,which may be useful in evalnatingpatients for adjuvant treatment

Objective To compare the effect of postoperative intercostal nerves cryoanalgesia and patient controlled epidural analgesia (PCEA) in patients undergoing thoracic surgery. Methods From April 2006 to May 2008,89 patients undergoing thoracic surgery were randomly divided into intercostal nerves cryoanalgesia group (group A,47 cases) and PCEA group (group B,42 cases). The scores of pain, use of pain medication and time of out-of-bed activity after the operation were used to evaluate the effect of pain between two groups. Results The scores of pain in group A and group B were (1.49 ± 0.80) and (2.43 ± 1.21) scores respectively. There were significant differences in the scores of pain. The use of pain medication [(1.28 ± 0.62) times vs (2.02 ± 1.05) times]and time of out-of-bed activity after the operation [(43.15 ± 12.22) h vs (64.10 ± 14.25) hi were significant difference between the two groups(P< 0.05). Conclusions For reducing the post- thoracotomy pain,intercostal nerves cryoanalgesia is superior to PCEA. Intercostal nerves cryoanalgesia can provide satisfactory analgesia after thoracic surgery.

Objective To explore the effective methods of increasing the symmetry of blepharoplas-ty. Methods The two eyelids were synchronously incised, and equal amount of musculi dormitator and fat tissues removed. Firstly, suture at the golden point of intersection for one eyelid, then suture the same point on the other one, and carefully compare the symmetry of both eyelids. Results All the 31 patients, except 1, were satisfied with the results of the symmetry with same height and length. Conclusion Syn-chronously incising the two eyelids and suturing at the symmetrical points by comparison can evidently in-crease the symmetry of blepharoplasty.

ObjectiveTo investigate the current situation of postoperative fluid therapy in general surgery department of grade Ⅲ-A general hospitals in Beijing and Tianjin. Methods Postoperative patients in general surgery department who were fasting for 3 days were retrospectively investigated, and 600 cases were recruited without considering age, gender, denomination of disease and operation type.The general information of patients, laboratory examination before and after operation, postoperative fluid therapy for 3 days, postoperative complications and infusion reaction were collected.Results In total 588 valid cases, the volume of average fluids supplement was (3030±638)ml per day, With the prescribed glucose (142+67)g per day, potassium chloride (59.9±23.9) mmol per day and sodium chloride (179.5±66.7) mmol per day. 85.2 % of total patients received nutrition support and the ratio of parenteral nutrition/enteral nutrition (PN/EN) was 28/1.There were 549 patients with BMI>18.5 before operation, and among them, 470 cases (85.6%)received parenteral and enteral nutrition treatment. There were 39 patients with BMI < 18.5 and 27 cases (69.2%) received parenteral nutrition support without enteral nutrition treatment. During the 3 days after operation, there were 36 cases with fluid therapy without potassium chloride supplement.ConclusionsThe proportions of receiving nutrition support and parenteral nutrition treatment are relatively high in grade Ⅲ-A general hospitals in Beijing and Tianjin. Ready-to-use preparation canreduce mistake and will be benefit to patients.

Objective To evaluate the prediction value on distant metastases of fib bone marrow micrometastases (BMM) of patients with non-small lung cancer ( NSCLC ). Methods From January 2003 to March 2006, 168 patients undergoing surgical treatment for NSCLC were prospectively investigated for the presence of BMM by using immnnohistochemistry. The sensitivity and specificity of the rib bone marrow micrometastases technique were also calculated. Receiver operating characteristic curve (ROC curve)was drawn according to data. Results Occult BMM were detected in 29.76 %(50/168) of patients with NSCLC. 15(29.76 %) patients developed metastases in the 50 patients with BMM and 15 (12.71%) patients developed metastases in the 118 patients without BMM. The sensitivity and the specificity of the technique was 61.54 % and 79.84 %. The false negative rate was 38.46 % and the false positive rate was 20.16 %. The positive predictive value, negative predictive value and Youden' s index were 87.5 %, 93.33 %, 74.33 % respectively. Conclusion The detection of BMM could predict the distant metastases of non-small lung cancer patients through receiver operating characteristic curve evaluation, however, the detecting sensitivity should be improved.

Objecflve To determine the prevalences of nutritional risk,undemutrition,overweight,and obesity as well as nutritional support and the changes of nutritional risks from admission to discharge or over a two-week period.Methods A consecutive sampling was performed.Dam were collected from general surgical depart-ments in three Beijing teaching hospitals from March to July in 2007.Patients were screened using Nutritional Risk Screening 2002(NRS2002)on admission and two weeks after admission(or discharge).The nutritional supper apphcation during hospital stay was recorded.NRS2002 score≥3 was classified as nutritional risk.BMI<1 8.5kg/m2 with impaired genend condition was defined as undemutrition.Results Among 300 enrolled patients,the NRS2002 WaS completed by 99.0%(297/300)of all patients.The nutritional risk and the prevalence of under_nutrition,overweight,and obesity was 30.0%,8.1%,38.3%,and 9.4%,respectively at admission.Fifty of 90(62.2%)patients who were at nutritional risk received nutritional support while 40 of 210(19.O%)non-risk patients received nutritional support.Especially among major abdominal surgery patients,56 of 90(71.6%)pa-tients who were at nutritional risk received nutritional supper while 35 of 81(43.2%)non-risk pafients received nutritional support.The prevalence of nutritional risk changed from 30.0%to 35.8%(X2=2.271,P=0.132).Conclusions NRS2002 is a feasible nutritional risk screening tool among general surgical pafienm in selected Bei-jing teaching hospitals.Nutritional support is somehow inappropriately apphed in general surgical hospitalized pa-tients.The prevalence of nutritional risk remains unchanged in general surgical patients during hospitalization.

The three steps of nutritional care in Europe, the United States and China were basically same as [Nutritional screening-assessment-intervention]. This review article discussed the second step of GLIM for diagnosis of malnutrition, when the diagnosis of malnutrition being needed. No normal range in healthy volunteer and no cut-off point based on clinical studies for FFMI in China now.

Objective:To systematically review the methodology in clinical trial-based health economics study with cost-effectiveness ratio for nutritional drug.Methods:The literature on health economics study for nutritional drug was retrieved from PubMed and Wanfang Medical Network by October 2019. The literature was selected according to inclusion and exclusion criteria, and was assessed using the Cochrane Risk Bias Assessment Tool and Newcastle-Ottawa Scale. Its methodology such as participants and grouping, confounding factors, research perspective, cost accounting, health outcomes and health economics analysis methods, sensitivity analysis, etc, was systematically reviewed as well.Results:Four target literatures were included in this study. The participants were from gastroenterology, gastrointestinal surgery, etc. Random grouping, regression, propensity score matching method, etc, were used to control confounding factors. The research perspective needed to be clear according to the principle of health economics study. The present literatures focused on "direct medical costs" , and calculated cost-effectiveness ratio or incremental cost-effectiveness ratio to evaluate the economics of medical interventions.Conclusion:The evidence of high-quality health economics research in parenteral and enteral nutrition area in China needs to be promoted, especially in the control of confounding factors, the choice of research perspective and sensitivity analysis, which are supposed to be explored by multidisciplinary research teams in practice.