The aim of the study is to prepare flurbiprofen axetil nanoemulsion-in situ gel system (FBA/NE-ISG) and observe its ocular pharmacokinetics, rheological behavior, TEM images, irritation and cornea retention. Production of nanoemulsion was based on high-speed shear and homogenization process, and then mixed with gellan gum to prepare FBA/NE-ISG. Rheological study showed that FBA/NE-ISG possesses strong gelation capacity and its viscosity and elastic modulus increases by 2 Pa*s and 5 Pa respectively when mixed with artificial tear at the ratio of 40 : 7. TEM images suggested no significant changes in particle morphology of the pre and post gelation. Good ocular compatibility of FBA/NE-ISG was testified by the irritation test based on histological examination. In vivo fluorescence imaging system was applied to investigate the characteristics of cornea retention, and the results indicated that the nanoemulsion-in situ gel (NE-ISG) prolonged the cornea retention time significantly since K(NE-ISG) (0.008 5 min(-1) was much lower compared with flurbiprofen sodium eye drops (FB-Na, 0.03% w/v) of which the K(Eye drops) was 0.105 2 min(-1), indicated that the cornea retention time of NE-ISG was prolonged significantly. Pharmacokinetics of FBA/NE-ISG in rabbit aqueous humor was studied by cornea puncture, the MRT (12.3 h) and AUC(0-12h) (126.8 microg x min x mL(-1)) of FBA/NE-ISG was 2.7 and 2.9 times higher than that of the flurbiprofen sodium eye drops respectively, which meant that the ocular bioavailability was improved greatly by the novel preparation. Therefore, FBA/NE-ISG can enhance the ocular bioavailability by prolonging drug corneal retention significantly. What's more, encapsulated by emulsion droplets prodrug flurbiprofen (FBA) instead of flurbiprofen (FB) can reduce the ocular irritation.

The aim of the study is to prepare flurbiprofen axetil nanoemulsion-in situ gel system (FBA/NE- ISG) and observe its ocular pharmacokinetics, rheological behavior, TEM images, irritation and cornea retention. Production of nanoemulsion was based on high-speed shear and homogenization process, and then mixed with gellan gum to prepare FBA/NE-ISG. Rheological study showed that FBA/NE-ISG possesses strong gelation capacity and its viscosity and elastic modulus increases by 2 Pa?s and 5 Pa respectively when mixed with artificial tear at the ratio of 40∶7. TEM images suggested no significant changes in particle morphology of the pre and post gelation. Good ocular compatibility of FBA/NE-ISG was testified by the irritation test based on histological examination. In vivo fluorescence imaging system was applied to investigate the characteristics of cornea retention, and the results indicated that the nanoemulsion-in situ gel (NE-ISG) prolonged the cornea retention time significantly since KNE-ISG (0.008 5 min-1) was much lower compared with flurbiprofen sodium eye drops (FB-Na, 0.03% w/v) of which the KEye drops was 0.105 2 min-1, indicated that the cornea retention time of NE-ISG was prolonged significantly. Pharmacokinetics of FBA/NE-ISG in rabbit aqueous humor was studied by cornea puncture, the MRT (12.3 h) and AUC0→12 h (126.8 ?g?min?mL-1) of FBA/NE-ISG was 2.7 and 2.9 times higher than that of the flrubiprofen sodium eye drops respectively, which meant that the ocular bioavailabilitywas improved greatly by the novel preparation. Therefore, FBA/NE-ISG can enhance the ocular bioavailability by prolonging drug corneal retention significantly. What’s more, encapsulated by emulsion droplets prodrug flurbiprofen (FBA) instead of flurbiprofen (FB) can reduce the ocular irritation.

Objective:To study the effects of different processes on diosgenin content in polygonatum from Shaanxi. Methods:The content of diosgenin was determined by HPLC on a column of Woburn C18 (250 mm × 4. 6 mm, 5 μm) with the mobile phase of acetonitrile-water(90 ∶10)at the flow rate of 1.0 ml·min-1, the detection wavelength was 203 nm, the column temperature was 30℃, and the injection volume was 30 μl. Results:The linear range of diosgenin was 0. 892-5. 352 μg(r=0. 999 9), and the aver-age recovery was 99. 5% (RSD=2. 53%). The content of diosgenin was significantly various among the samples of polygonatum with different processes from Shaanxi (P<0. 05), and that in the raw slices was the highest followed by the steam samples, while that in al-cohol evaporate slices was the lowest. Conclusion:The results of the research can provide reference for the quality control and process-ing methods of polygonatum from Shaanxi.

Objective To evaluate operation method in with microscopic flap breast reconstruction after breast cancer case management care blueprint. Methods According to the building of case management care blueprint, according to the questions, plan, action, observation and reflection, improvement of summarizing the research process, formulate, modify with microscopic flap breast reconstruction after breast cancer case management care blueprint, and applied to clinical. Results Through the research of two phase research analyses the results after the intervention. Microscopic flap breast reconstruction after breast cancer patients′ quality of life evaluation, cancer, mental adaptation level, determination of postoperative body image, adjust the importance of breast score in the first stage, respectively (28.54 ± 3.78), (13.56±2.51), (2.71±1.08), (3.00±0.87) points, the second phase, respectively (80.32 ± 5.94), (45.02 ± 3.51), (6.85 ± 0.36), (7.34 ± 0.66) points. Two phase comparison difference was statistically significant (-47.070--21.551, P<0.05 or 0.01). Conclusions Based on the study of action with microscopic flap breast reconstruction after breast cancer case management care blueprint to build, implement the evaluation, plan, service, coordination and monitoring of health care management system, improve the patients′ life quality, standardize nursing process, improve the effect of nursing quality.

Objective:To investigate the attentional bias for negative emotional facial expressions in major depressive disorder(MDD).Methods:Twenty MDD participants were selected from a larger pool of patients (n=35),diagnosed as depression with the Chinese Classification and Diagnostic Criteria of Mental Disorders Version 3 (CCMD-3),according to the Hamilton Depression Scale (HAMD) and Beck Depression Inventory (BDI).And 20 non-depression control participants(NC)matched with MDD group on age,gender and education level.All participants completed an exogenous cueing task which consisted of two kinds of cue types(valid and invalid trial)and two kinds of face types(neutral faces and negative faces).Results:Patients with MDD showed more larger cue validity effect for negative faces compared with neutral faces(21.73 ms vs.3.91 ms,P<0.01).They showed a stronger attentional engagement for negative faces in comparison with non-depressed participants(17.25 ms vs.1.64 ms,P<0.001).The NC group directed attention away from negative faces,more rapidly disengaging their attention compared with MDD,but the differences showed no significant(-1.50 ms vs.0.57 ms,P>0.05).Conclusion:These results support the assumption that MDD is associated with attentional bias for negative information,and deficits protective bias for it.

Objective To observe the outcome of free TAAP flap in the reconstruction of defect after oral tumor radical resection.Methods From June,2010 to April,2015,12 patients with oral tumor underwent radical resection,including 4 cases of gingival carcinoma,3 cases of tongue carcinoma and 5 case of buccal cancer.The cause ranged from 2 to 12 months.The radical resection left defects with size ranged from 4.5 cm×3.5 cm to 6.0 cm× 4.5 cm which were reconstructed by free TAAP flaps with size ranged from 7.0 cm×4.0 cm to 12.0 cm×8.0 cm.The length of TAAP flap was (6.5±0.6) cm.The width of flap was (4.3±0.5) cm.And the thickness of flap was (1.1±0.3)cm.The length of pedicle was(8.4±0.2) cm.All the arteries of TAAP were anastomosed with superior thyroid arteries,while the venae comitans were anastomosed with superior thyroid venae or internal jugular venae.Results The perforators existed consistently.All 12 flaps survived uneventfully.The donor sites were closed directly in all cases.All patients were followed up for 14-38 months with satisfied esthetic and functional results in reconstructed tongue.No local recurrence happened.The shoulder function was not affected.Conclusion The TAAP flap has consistent blood supply,good color match and texture,while leaving minimal morbidity at donor site,is an ideal choice for buccal tumor reconstruction.

Objective: To investigate the application of free medial thigh chimeric myocutaneous perforator flap in the reconstruction of tongue defect after radical resection of tongue carcinoma. Methods: From June 2013 to November 2015, 17 cases with tongue carcinoma underwent radical resection and tongue and mouth floor defects after surgery were reconstructed with medial thigh chimeric myocutaneous perforator flaps at the same stage. These 17 cases included tongue carcinoma on lingual margin (n=9), ventral tongue (n=7) and mouth floor (n=1). Appearance and functional results were evaluated with follow-up. Results: Medial thigh chimeric myocutaneous perforator flap was (9.0±0.3) cm in length, (4.5±0.3) cm in width , and (1.8±0.4) cm in thickness. The length of pedicle was (7.4±0.6) cm. All of the 17 flaps survived uneventfully, and the donor sites were closed directly in all cases. All patients were followed up for 10-28 months with satisfied esthetic and functional results in reconstructed tongue. Aside from linear scar in the donor sites, the functions of thighs were not affected. No local recurrence occurred. Conclusion The free medial thigh chimeric myocutaneous perforator flap is an ideal choice to reconstruct the tongue and mouth floor defect after radical resection of tongue carcinoma.

Objective:To explore the necessity of combined transverse upper gracilis flap and adductor magnus perforator flap in breast reconstruction.Methods:From December 2016 to February 2019, 16 female breast cancer patients, aged 27-59 years, with an average of 40.3 years, were treated in the Department of Oncoplastic Surgery, Hunan Cancer Hospital. The tumors were unilateral in 9 cases on the left side and 7 cases on the right side, with a diameter of 1.5-4.5 (2.9±0.3) cm, and all of them were stage I. Pathological diagnosis included 9 cases of invasive ductal carcinoma and 7 cases of invasive lobular carcinoma. After the modified radical mastectomy, the medial thigh perforator flap was used to reconstruct the breast. Patients were randomly divided into group A and group B. In group A, the gracilis myocutaneous flap combined with the adductor magnus perforator flap was elevated. In group B, the adductor magnus perforator flap with large size reaching the front edge of gracilis muscle was directly harvested. After all the flaps were harvested with only one major adductor perforator as vascular pedicle, ICG fluorescence imaging technology was used to verify the blood supply of the flaps.Results:Eight cases of gracilis myocutaneous flap combined with adductor magnus perforator flap and 8 cases of adductor magnus perforator flap were transplanted, The length, width and thickness of the flaps were (27.5±0.4) cm, (7.1±0.5) cm and (3.8±0.4) cm, (7.4±0.3) cm and (10.8±0.5) cm respectively. The average weight of the flap was 255 g (195 g-315 g). The mean ischemia time was 75 min (55-90 min). In 16 cases, the proximal and distal ends of internal mammary vessels were used as the recipient vessels. Only anastomosing the adductor magnus perforator vessels could ensure the reliable blood supply of the flap. All flaps survived successfully in one stage. The appearance of reconstructed breast was good and there was no obvious flap contracture and deformation. 16 cases were followed up for an average of 12.5 months, and the patients＇ self perception and appearance were satisfactory. Only hidden linear scar was left on the donor site of the medial thigh flap, and the function of hip joint and leg was not affected.Conclusions:Large size of medial thigh perforator flap pedicled with the perforator of adductor magnus can be safely and reliably cut with no needing additional harvest of gracilis muscle vascular pedicle.

Objective:To investigate the effect of peer support education on family function of breast cancer patients with breast reconstruction.Methods:Totally 146 patients who received surgical treatment in the department of plastic surgery for breast cancer from June 2017 to June 2019 were randomly divided into the experimental group and the control group by the method of random number table, 73 cases each. The control group received routine education. Patients in the observation group received regular education and peer support education. The intervention time was from admission to 6 months after discharge, and the control group received routine nursing care. Quality of life questionnaire was used to evaluate the quality of life of the patients at six months after operation, family care index questionnaire was used to evaluate the family function of the patients, and comprehend social support scale was used to evaluate the level of social support, then various indicators of the two groups of patients were compared.Results:6 months after operation, the scores of quality of life function and symptom dimension of the intervention group were 6.43±1.54. 5.83±1.47, while control group were 6.02±1.59; 6.39±1.63. There were statistically significant differences between the two groups ( t values were 4.30, 5.01, P < 0.05); family care scores of the two groups were compared, the intervention group was 8.78±2.04. The control group was 8.43±2.05. There were statistically significant differences between the two groups ( t value was 2.02, P < 0.05); the comprehension support score of the two groups was compared, and that of the intervention group was 62.24±14.81. The control group was 55.74±13.58. There were statistically significant differences between the two groups ( t value was 4.26, P < 0.05). Conclusion:Peer support education can improve the quality of life and family care of breast cancer patients with breast reconstruction.

Objective To review our single institutional 10-year experience in complex chest wall reconstruction and identify a working algorithm based on our retrospective analysis.Methods A retrospective analysis of 87 patients who underwent chest wallreconstruction in our department from January 2005 to December 2015.Fifty female patients and 37 male patients who underwent the above procedure were reviewed retrospectively.The median age of the patients is 52.3 years (24-75years).Histologic diagnosis including squamous-cell carcinoma (n =10),soft tissue sarcoma(n =22),chondrosarcomas(n =13) and metastasis from breast cancer(n =42).Type of skeletal defect including partial ribs/sternum defects in 19 cases,soft tissue defects alone in 33 cases,complicated composite chest wall defects involving multiple layers(soft tissue,ribs/sternum,and intrathoracic organs) in 35 cases.Sole methylmethacrylate/polypropylene mesh was used for small sized rib defects in 26cases.Methylmethacrylate/polypropylene mesh sandwich prostheses was used in 28 cases with extensive skeletal reconstruction after partial sternectomy and rib resection.The chest wall defects were repaired with pedicled internal mammary artery perforator flap(3 cases),pedicled deep superior epigastric artery perforator flap(4 cases),pedicled pectoralis major flap(8 cases),free anterolateral thigh perforator flap(9 cases),free deep inferior epigastric artery perforator flap(17 cases),pedicled lateral thoracic flap(5 cases),pedicled latissimus dorsi flap(17 cases),pedicled rectus abdominis flap(15 cases),free deep inferior epigastric artery perforator flap combined with pedicled rectus abdominis flap (4 cases),pedicled bipaddled latissimus dorsi flap(5 cases).11 cases with extensive full-thickness defects of the chest wall,the skeletal reconstruction was achieved with prosthetic sandwich and then covered with the omental flap,further free flaps were harvested for skin and soft tissue repairing.Results 1 case with pedicled rectus abdominis flap partial necrosis was noted,free anterolateral thigh flap was used for repairmen after further revision.1 case with edicled bipaddled latissimus dorsi flap,necrosis of the distal 1/4 part of one paddle was noted,healed with dressing therapy,no secondary skin grafting was required.Postoperative venous congestion occurred in 2 cases with deep inferior epigastric artery flap transplantation,in which both skin flaps exhibited venous crisis within 24 h after surgery.The reexploration procedures were successful in both cases and the flaps survived totally.All other flaps survived.The mean follow-up was 31 months,ranged from 9 to 72 months.No tumour extirpation was noted,functional and appearance results were satisfied.Conclusion According to the size and location of chest wall defect,different pedicled and free flaps should be chosen to achieve optimal outcome.Free flaps are efficient for large complex chest defects reconstruction.