Objective To investigate the clinical efficacy and cosmetic outcome of two methods of immediate breast reconstruction and modified radical mastectomy for the patients with breast cancer after breast cancer surgery. Methods The clinical data of 95 patients with early breast cancer in the First Affiliated Hospital of Jinzhou Medical University from October 2014 to September 2018 were retrospectively analyzed. The patients were divided into latissimus dorsi combined with implants group (27 cases), titanium-coated polypropylene mesh combined with implants group (18 cases) and modified radical group (50 cases). The differences of surgical data, postoperative complications and quality of life were compared in the three groups. The postoperative cosmetic effect of two immediate reconstruction groups was observed. Results The differences of drainage duration and intraoperative blood loss in the three groups were not statistically significant (both P > 0.05). There were statistical differences in the hospital stay and the postoperative quality of life score (both P < 0.01). The incidence of postoperative complications in latissimus dorsi combined with implants group, the titanium-coated polypropylene mesh combined with implants group and the modified radical group was 48.1％ (13/27), 22.2％ (4/18) and 12.0％ (6/50), respectively. And the difference between latissimus dorsi combined with implants group and the modified radical surgery group was statistically significant (χ 2 = 12.33, P < 0.01). The good rate of cosmetic effect in titanium-coated polypropylene mesh group was higher than that in latissimus dorsi combined with implants group, and there was no statistically significant difference [83.3％ (15/18) vs. 81.5％ (22/27), χ 2 = 0.025, P > 0.05]. Conclusions Immediate breast reconstruction including latissimus dorsi combined with implants or titanium-coated polypropylene mesh combined with implants after radical mastectomy on the basis of indications can improve the quality of life and the cosmetic results of patients, but postoperative treatment is necessary for the increased complications after the two reconstruction methods.

Objective:To investigate the effect of different negative pressure level on drain volume after augmentation mammoplasty through inframammary fold incision, and try to put forward the appropriate negative pressure level for the best prognosis of patients.Methods:This was a randomized controlled clinical study. Patients who underwent prosthetic augmentation mammoplasty through inframammary fold incision in the Medical Beauty Center of the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2021 were selected as the study subjects. Patients were divided into 4 groups by random number table method and different levels of negative pressure drainage were applied: 600 ml adjustable negative pressure drain bottle was used uniformly after operation by -80--85 kPa group, -40--60 kPa group, and -15--30 kPa group. In 0--5.2 kPa group, 300 ml drain drum was applied after operation. The criteria for drain removal was that the drain volume within 24 hours was less than 10 ml and the drainage fluid was clear. Daily drain volume, duration of drain placement, total drain volume, acceptance of the drain device and postoperative complications were recorded in the four groups. The corresponding indexes of each group were statistically analyzed by SPSS 21.0. Measurement data were expressed as Mean±SD. One-way analysis of variance was used for comparison between groups, and LSD- t test was used for pair comparison between groups. P<0.05 was considered statistically significant. Results:A total of 80 patients were included, 20 in each group. Inter-group equilibrium analysis: there was no significant difference in age, body mass index, distance from midclavicular point to nipple, distance from inferior mammary fold to nipple, and breast tissue thickness among 4 groups ( P>0.05). Evaluation of curative effect between groups: on the first and second day after operation, there was no significant difference in drain volume between -80--85 kPa group and -40--60 kPa group ( P>0.05), but there was significant difference among other groups ( P<0.05). There was significant difference in drain volume on the third day after operation, total drain volume and duration of drain placement between the four groups ( P<0.05). The lower the negative pressure level was, the less drain volume on the third day after surgery and the less total drain volume, and the shorter duration of drain placement. The duration of drain placement of the four groups were (5.6±0.7) d (-80--85 kPa group), (4.8±0.5) d (-40--60 kPa group), (4.0±0.5) d (-15--30 kPa group), and (3.2±0.4) d (0--5.2 kPa group), respectively. Safety evaluation: the complication rate of -80--85 kPa group, -40--60 kPa group, -15--30 kPa group and 0--5.2 kPa group were 2.5% (1/40), 2.5% (1/40), 0(0/40) and 15.0% (6/40), respectively. The complication rate of 0--5.2 kPa group was the highest. Investigation on the acceptance of the drainage device (no impact/dissatisfaction): 75 patients expressed dissatisfaction, with a dissatisfaction rate of 93.75%(75/80). Conclusion:In augmentation mammoplasty through inferior fold incision low negative pressure provides less drain volume, shorter drain placement. Negative pressure between -15 to -30 kPa is optimal.

Objective:To investigate the effect of different negative pressure level on drain volume after augmentation mammoplasty through inframammary fold incision, and try to put forward the appropriate negative pressure level for the best prognosis of patients.Methods:This was a randomized controlled clinical study. Patients who underwent prosthetic augmentation mammoplasty through inframammary fold incision in the Medical Beauty Center of the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2021 were selected as the study subjects. Patients were divided into 4 groups by random number table method and different levels of negative pressure drainage were applied: 600 ml adjustable negative pressure drain bottle was used uniformly after operation by -80--85 kPa group, -40--60 kPa group, and -15--30 kPa group. In 0--5.2 kPa group, 300 ml drain drum was applied after operation. The criteria for drain removal was that the drain volume within 24 hours was less than 10 ml and the drainage fluid was clear. Daily drain volume, duration of drain placement, total drain volume, acceptance of the drain device and postoperative complications were recorded in the four groups. The corresponding indexes of each group were statistically analyzed by SPSS 21.0. Measurement data were expressed as Mean±SD. One-way analysis of variance was used for comparison between groups, and LSD- t test was used for pair comparison between groups. P<0.05 was considered statistically significant. Results:A total of 80 patients were included, 20 in each group. Inter-group equilibrium analysis: there was no significant difference in age, body mass index, distance from midclavicular point to nipple, distance from inferior mammary fold to nipple, and breast tissue thickness among 4 groups ( P>0.05). Evaluation of curative effect between groups: on the first and second day after operation, there was no significant difference in drain volume between -80--85 kPa group and -40--60 kPa group ( P>0.05), but there was significant difference among other groups ( P<0.05). There was significant difference in drain volume on the third day after operation, total drain volume and duration of drain placement between the four groups ( P<0.05). The lower the negative pressure level was, the less drain volume on the third day after surgery and the less total drain volume, and the shorter duration of drain placement. The duration of drain placement of the four groups were (5.6±0.7) d (-80--85 kPa group), (4.8±0.5) d (-40--60 kPa group), (4.0±0.5) d (-15--30 kPa group), and (3.2±0.4) d (0--5.2 kPa group), respectively. Safety evaluation: the complication rate of -80--85 kPa group, -40--60 kPa group, -15--30 kPa group and 0--5.2 kPa group were 2.5% (1/40), 2.5% (1/40), 0(0/40) and 15.0% (6/40), respectively. The complication rate of 0--5.2 kPa group was the highest. Investigation on the acceptance of the drainage device (no impact/dissatisfaction): 75 patients expressed dissatisfaction, with a dissatisfaction rate of 93.75%(75/80). Conclusion:In augmentation mammoplasty through inferior fold incision low negative pressure provides less drain volume, shorter drain placement. Negative pressure between -15 to -30 kPa is optimal.

OBJECTIVE: To analyze the prognosis of fetuses with cystic hygroma (CH) or nuchal translucency (NT) or nuchal fold (NF) thickening detected by prenatal echography. METHODS: From January 2014 to December 2015, 124 fetuses with CH and NT/NF thickening on prenatal echography were enrolled from Women's Hospital of Zhejiang University School of Medicine. The basic clinical information, ultrasonic results, pregnancy outcomes and newborn follow-ups were analyzed. The cases were grouped by prognosis and the factors affecting prognosis were analyzed with logistic regression. RESULTS: There were 85 cases of labor induction including one stillbirth and 39 cases delivered. Except one infant who died after birth, all live births survived with good prognosis. Univariate analysis showed that the gestational age at diagnosis of poor prognosis group was earlier than that of good prognosis group (<0.01); and the former group also had higher hydrops fetalis rate and additional structural anomalies rate (all <0.01). Multivariate regression analysis showed that hydrops fetalis (=90.105, <0.05) and additional structural anomalies (=61.854, <0.05) were risk factors of poor prognosis in fetuses with CH and NT/NF thickening. CONCLUSIONS Fetuses with diagnosed CH or NT/NF thickening on prenatal ultrasonography are likely to be associated with chromosomal abnormality. Early gestational weeks, hydrops fetalis and additional structural anomalies may indicate poor prognosis.
Female ; Fetus ; Humans ; Hydrops Fetalis ; etiology ; Infant, Newborn ; Lymphangioma, Cystic ; complications ; diagnosis ; Nuchal Translucency Measurement ; Pregnancy ; Pregnancy Outcome ; Prognosis ; Ultrasonography, Prenatal

The axon initial segment (AIS) is a highly specialized axonal compartment where the action potential is initiated. The heterogeneity of AISs has been suggested to occur between interneurons and pyramidal neurons (PyNs), which likely contributes to their unique spiking properties. However, whether the various characteristics of AISs can be linked to specific PyN subtypes remains unknown. Here, we report that in the prelimbic cortex (PL) of the mouse, two types of PyNs with axon projections either to the contralateral PL or to the ipsilateral basal lateral amygdala, possess distinct AIS properties reflected by morphology, ion channel expression, action potential initiation, and axo-axonic synaptic inputs from chandelier cells. Furthermore, projection-specific AIS diversity is more prominent in the superficial layer than in the deep layer. Thus, our study reveals the cortical layer- and axon projection-specific heterogeneity of PyN AISs, which may endow the spiking of various PyN types with exquisite modulation.
Mice ; Animals ; Axon Initial Segment ; Synapses/physiology* ; Pyramidal Cells/physiology* ; Cerebral Cortex ; Axons/physiology*