Objective To introduce a method of functional reconstruction for total lower lip defects.Methods Six patients with lower lip cancer were treated by surgery from November 2007 to February 2009.The full thickness defects with a size from eighty percent to total lower lip were reconstructed with two triangular mental neurovascular island flaps of chin.The musculocutaneous and mucous flaps with neurovascular pedicles were advanced in a V-Y manner to close the defect and reconstruct the orbicularis oris muscle.Results All flaps survived and no recurrence and complication were observed and showed excellent cosmetic and functional results over 6 months of follow-up.The reconstructed lower lips provided a wide-enough mouth opening,and the sensation of oral mucosa and the muscle function of oral sphincter were preserved.Conclusions The technique of mental neurovascular V-Y advancement island flap can get satisfactory results in both functional and the aesthetic perspects.

OBJECTIVETo investigate the impact of intrauterine infection induced by LPS injection on long-term brain development of premature rats.

METHODSEighteen day-gestation pregnant rats were randomly assigned to a control group receiving an intraperitoneal injection of normal saline, and two infection groups that were intraperitoneally injected with 0.3 mg/kg or 0.6 mg/kg LPS. Twenty-four hours after injection, 7 pregnant rats of each group were sacrificed. The pathological changes of the placenta after hematoxylin and eosin staining were observed under a light microscope. The neural cell apoptosis of fetal brains was examined by the TUNEL assay. The remained pregnant rats were induced to labour before 21 gestation days. The long-term brain development of premature rats was tested with the Y type electric maze on postnatal day 42.

RESULTSObvious pathological changes were observed in the placenta in the infection groups. The apoptotic neural cells in the fetal brain increased in the infection groups compared with that in the control group (32.41+/-5.36 in the 0.3 mg/kg infection group and 66.41+/-7.61 in the 0.6 mg/kg infection group vs 8.00+/-0.36 in the control group; P<0.01). The number of trials to criterion in the Y type maze test in the infection groups was much more than that in the control group [117.8+/-8.7 (0.3 mg/kg infection group) and 194.4+/-13.7 (0.6 mg/kg infection group) vs 56.8+/-3.7 (control group); P<0.01]. The number of correct reactions in memory retaining in the infection groups was lower than that in the control group (0.62+/-0.09 in the 0.3 mg/kg infection group and 0.37+/-0.09 in the 0.6 mg/kg infection group vs 0.92+/-0.06 in the control group; P<0.05).

CONCLUSIONSIntrauterine infection can cause fetal rats' neural cell apoptosis and affect adversely long-term brain development of neonatal rats.

Animals ; Apoptosis ; Bacterial Infections ; physiopathology ; Blood-Brain Barrier ; Brain ; growth & development ; pathology ; Female ; Maze Learning ; Neurons ; pathology ; Pregnancy ; Pregnancy Complications, Infectious ; physiopathology ; Rats ; Rats, Wistar ; Uterus ; microbiology

Objective To evaluate the accuracy of Hadeco ES-1000spm hand-held doppler during the anterolateral thigh(ALT)flap harvest.Methods Twenty-five patients(26 sides)with ALT flaps for head and neck reconstruction between May 2005 and May 2010 received preoperative Doppler examination for the location of the cutaneous perforators of ALT flaps.The Doppler signals and body mass index(BMI)were recorded preoperatively according to ABC system.The locations of Doppler signals and of the actual cutaueous perforators at surgery were plotted and compared.The diameter of perforators was measured.Results One to three cutaneous perforators of the ALT flap were consistently found at specific locations.They were named perforators A,B,C from proximal to distal.Perforators A,B and C were present in 15(58%),24(92%)and 20(77%)cases and the diameter(>0.5 mm)of A,B and C were 11/15,22(92%)and 8(40%)respectively.The Doppler signal was within 0.5 cm of the actual perforator location in 85% flaps.The accuracy of Doppler decreased with increase of BMI.Conclusions Preoperative assessment by hand-held Doppler is useful in predicting the perforator vessels'locations and diameter although it's accuracy is limited.

Objective To develop a simultaneous determination method of risperidone,paliperidone,olanzapine and quetiapine in human serum for therapeutic drug monitoring.Methods Clinical serum samples were prepared by protein precipitation and analytes were determined using HPLC-MS/MS.An Eclipse XDB C1s column (4.6 mm ×50 mm,1.8μm) was combined with mobile phase consisted of methanol,water and acetrile (37.5:12.5:50,plus 2.5 mmol · L-1 ammonium formate).The flow rate was 0.5 mL · min-1 The column temperature was 35 ℃ and the injection volume was 2 μL.MS detection was carried out using an electrospray ionization source operated in multiple reaction monitoring (MRM) mode.The ion transitions were m/z 427.3 → m/z 207.2(paliperidone),m/z 431.3--m/z 211.2 (paliperidone-D4),m/z 411→m/z 191 (risperidone),m/z 415.4→m/z195.2 (risperidone-D4),m/z 384.3→m/z 253.1 (quetiapine),m/z 392.3→m/z 258 (quetiapine-D8),m/z313→m/z 256 (olanzapine),m/z 316→m/z 256 (olanzapine-D3),respectively.Results The calibration curves of risperidone and paliperidone were y =0.67x +4.94 × 10-4 (R2 =0.999 4) and y =0.68x +0.14 × 10-2 (R2 =0.999 6),with the linear ranges of 1-100 ng · mL-1.The linear ranges were 2-200 ng · mL-1(calibration curve:y =1.33x-0.65 × 10-2,R2 =0.998 6) for olanzapine and 8-800 ng· mL-1 (calibration curve:y =1.80x-2.08 × 10-2,R2 =0.999 4) for quetiapine.The inter and intra-batch precisions of risperidone,paliperidone,olanzapine and quetiapine were all within 15 ％ in lower limit of quantitation (LLOQ),low,middle and high levels of quality control samples.The extraction efficiency was more than 90％ for four analytes.The concentration of analytes in quality control samples were less than ± 15 ％ bias compared with nominal concentration after storage at room temperature for 24 h,-70 ℃ for 34 d or after freeze-thaw for 3 cycles.Conclusion The validated method was simple,fast and sensitive for the simultaneous determination of risperidone,paliperidone,olanzapine and quetiapine in human serum.The method was applied to the therapeutic drug monitoring for patients administered with the above drugs.The stability of mixed quality control samples is reliable and can be used for therapeutic drug monitoring.

Insomnia and depression are common mental disorders and there exists bidirectionality between sleep symptoms and depressive symptoms.Cognitive behavioral therapy for insomnia (CBT-I) is recommanded first in patients with accute or chronic insomnia.Phannacotherapy treatment is recommended when CBT-I is insufficient or patients are comorbided with depression or other mental diseases.Pharmacotherapy treatment options include antidepressants,benzodiazepines,non-benzodiazepines,atypical antipsychotics as monotherapy or cotherapy.The aim of the present review was to discuss the selection and clinical application of sedative-hypnotic drugs in patients with comorbid depression and insomnia.

Objective To evaluate the uncertainty in the determination of lamotrigine (LTG) in human serum with high performance liquid chromatography (HPLC).Methods It was analyzed that the influences of various factors for detection results,including weighing,solution preparation,serum extraction,calibration curve fitting repeatability and so on.The expanded uncertainty was evaluated and combined by each component of uncertainty.Results The expanded uncertainty of lamotrigine at low (1.50 μg · mL-1),middle (8.00 μg · mL-1),high (20.00 μg · mL-1) concentrations were UL =0.30,UM =0.53,UH =0.98,respectively (P =95％,k =2).The corresponding test concentration were (1.51 ±0.30),(8.22±0.53),(20.40±0.98) μg · mL-1,respectively.Conclusion The relative uncertainty on the determination of lamotrigine in human serum by HPLC was mainly caused by repeatability,calibration curve fitting and extraction recovery;repeatability and calibration curve fitting were the important factor in influencing the results of low concentrations.

Objective To investigate the influential factors of serum drug concentration/dosage ratio (C/D) for schizophrenia patients after oral administration of risperidone.Methods Medical records of inpatients who received oral administration of risperidone in Guangzhou Huiai Hospital during 2016 were consulted and the C/Ds were calculated.Effects of age,gender,dosage form,combined medication,comorbidity and serum concentration ratio of 9-OH risperidone and risperidone were evaluated.Results C/D in patients aged 60 or older was (10.06 ± 6.61) ng · mL-1 · mg-1 · d.It was significantly larger than those under 60 years old,which were (7.82 ± 3.31) and (8.02 ±4.05) ng · mL-1 · mg-1 · d for 40-59 and under 40 years old,respectively.In addition,C/D was decreased with the increase of 9-OH risperidone/ risperidone ratio.The C/D were(10.96 ±6.46),(8.71 ±4.45)and (6.30 ± 2.99) ng · mL-1 · mg-1 · d for 9-OH risperidone/risperidone ratio ＜ 1,1-10 and ＞ 10,respectively.Gender,dosage form andthe major combined medications and comorbidities in the recruited patients hardly affected the C/D of oral risperidone.Conclusion The dose of risperidone that administered to the aged should be reduced properly.Serum concentration ratio of 9-OH risperidone and risperidonehas a potential to be used as an indirect index of the activity of metabolic enzymes.

We aimed to confirm the predictive ability of the presence of intraductal carcinoma of the prostate (IDC-P) for prognosis and the associations between IDC-P and clinicopathological parameters. Studies were identified in PubMed, Cochrane Library, EMBASE, Web of Science, and SCOPUS up to December 1, 2019. Hazard ratios (HRs) for survival data and odds ratios for clinicopathological data with 95% confidence intervals (CIs) were extracted. Heterogeneity was evaluated by the I

Child ; Consensus ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Respiratory System