OBJECTIVETo investigate the clinical application of expanded flap based on cutaneous branch of transverse cervical artery for reconstruction of cervical cicatricial contracture.

METHODSBased on the clinical anatomy of cutaneous branch of transverse cervical artery flap, we design the corresponding subclavicular area for expansion. The incision was usually located at the anterior axillary fold, 5-8 cm in length. The expander was implanted under the deep fascial layer, without injury of the vascular pedicle. Fixation sutures were put about 1 cm apart from the incision to prevent the expander from transposition and exposure. After expansion, the cervical cicatricial contracture was excised and released. According to the defect, the expanded flap based on the cutaneous branch of transverse cervical artery was designed, with the pedicle located at the posterior margin of sternocleidomastoid and 1. 8 cm above median point of clavicle. "S" shape incision was made at the location of vascular pedicle. Subcutaneous dissection was performed 1.5 cm in width along the incision on both sides. Then the flap was harvested under the deep fascial layer and rotated to cover defect without tension. It was not necessary to dissect the vascular pedicle further. The defect at donor site was closed directly.

RESULTS17 cases were treated with the island flap. The contracture of the cervical scar was corrected completely with aesthetic appearance.

CONCLUSIONSExpanded flap based on cutaneous branch of transverse cervical artery has reliable blood supply. It' s an ideal flap for the treatment of cervical cicatricial contracture.

Arteries ; Cicatrix ; surgery ; Clavicle ; Contracture ; surgery ; Dissection ; methods ; Fasciotomy ; Humans ; Neck ; blood supply ; Neck Muscles ; anatomy & histology ; Surgical Flaps ; blood supply

Amifostine ; therapeutic use ; Animals ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Oral Health ; Radiation Injuries ; etiology ; prevention & control ; therapy ; Radiation-Protective Agents ; therapeutic use ; Radiotherapy ; adverse effects ; Radiotherapy, Conformal ; Salivary Glands ; radiation effects ; Salivation ; radiation effects ; Submandibular Gland ; surgery ; transplantation ; Xerostomia ; etiology ; prevention & control ; therapy

Objective To learn current status of health management provided by primary health professionals working in rural areas of Beijing.Methods Health professionals in township hospitals in Beijing were selected by multi-phase random sample method in 2012 and surveyed by a standardized questionnaire to gathering the data on various health management contents,including health checkup,chronic disease management et al,the action location,its collaborative persons and sectors.Statistics description and inference were conducted to describe and compare the distribution of health management implementation across rural areas by descriptive methods and test,respectively.Results Nearly 66.3％ (321/484) of subjects provided health check-up,and 19.1％ (92/481)involved in follow-up study of mental diseases.The main targets population of health management were chronic diseases and the elderly,with response rate of 44.7％ (214/479) and 38.0％ (182/479),respectively.Health check-up,health education and follow-up of chronic diseases were performed in 62.1％ (298/480),52.4％ (251/479) and 42.8％ (206/481) of the township health centers.About 66.1％ (292/442) township health centers had cooperation with general practitioners; however,cooperation with administrative personnels was only 10.6％ (47/443).More than 41.4％ (201/463) township health centers cooperated with community administrative sectors,and cooperation with the propaganda department was only 10.6％ (49/464).The statistical difference across regions shows in the following,including health management action (health checkup,chronic disease patients following-up,et al),the target population covered (youth,elder person,children,and chronic disease patients),health management location(health checkup,education and chronic disease patients following-up in township hospital and village clinic),cooperation with General Practitioner.Conclusions Our results suggest that the actual situation on health management service in Beijing rural areas and the standards of public health equalization of China are still disjoined,even difference exists across regions.In order to improve the health management service quality,we should strengthen the health management personnel training,increase the general practitioner in proportion,establish the performance evaluation mechanism,increase governmental finance to support those service.

Objective To explore the method of total nasal reconstruction when the forehead skin for expanding is unavailable.Methods According to the principle of total nasal reconstruction,total nasal scar and deformity were repaired with expanded random forearm falp.All the expanders were placed in flexor side of forearm.The incision sides were placed in proximal,distal,or lateral part of the forearm according to different pedicles.After expansion,the nares were enlarged,eversion of ala nasi corrected,the contracture scars sufficiently released,and the size and shape of the reconstructive nose designed according to face size.The scar of nasal dorsum and capsule of the expanded flap could be used for reconstructing nasal dorsum.Donor sides could be sutured directly,the pedicle could be cut 3 weeks later.Results All the flaps survived with good appearances,and 3 of the 15 cases with proximal,11 with distal,and 1 with lateral pedicle.The effect of distal pedicle group was better than that in proximal and lateral pedicle group because of comfortable posture longer pedicle,and providing more tissue for reconstruction.Conclusions Total nasal reconstruction with expanded random forearm flap is an option when the forehead skin for expanding is unavailable.

AIM:To investigate the effects of gonadotropin-releasing hormone ( GnRH) analogue on the growth of breast cancer cell lines MCF-7 and MDA-MB-231 in vitro and to explore the related mechanisms with PI 3K/Akt or ERK/MAPK pathways .METHODS: The proliferation of human breast cancer cell lines MCF-7 and MDA-MB-231 treatment with triptorelin was detected by MTT assay and the distribution of the cell cycle was determined by flow cytometry .The phosphorylation of the ERK 1/2 and Akt was evaluated by Western blotting .RESULTS:Triptorelin inhibited the prolifera-tion of MCF-7 cells at concentration of 10-5 mol/L after treated for 192 h or at concentration of 10 -4 mol/L after treated for 168 h and 192 h.Triptorelin inhibited the proliferation of MDA-MB-231 cells at concentration of 10 -4 mol/L after treated for 192 h (P<0.05).Treatment with triptorelin for 192 h at concentration of 10 -4 mol/L had no statistical significance effect on phosphorylation of ERK1/2 and Akt(P>0.05).CONCLUSION:Inhibitory effect of GnRH analogue triptorelin on human breast cancer cells is not just the connection with the down-regulation of pituitary hormone , but also a direct in-hibitory effect.The role may not be involved in the activation of ERK /MAPK and PI3K/Akt signaling pathways .

Gut microbiota(GM)consists of a complex community of microorganism species that live in the digestive tracts of animals including humans. Dysbiosis is believed to involve in the development of some diseases. Recently dysbiosis in the patients with Alzheimer′s disease(AD)and AD rat models was reported. GM may influence the pathogenesis and development of AD in several ways. Some neurotoxic substances produced by GM can invade into the brain via circulation and impair the neural functions. These sub?stances include ammonia,cyanobacteria-producedβ-N-methylamino-L-alanine,saxitoxin,anatoxin-αand amyloid. The decrease in brain-derived neurotrophic factor(BDNF)in hippocampus and cerebral cortex induced by dysbiosis contributes to the cognitive dys?function. Dysbiosis related endotoxin can induce inflammation,which is one important risk factor for obesity,insulin resistance(IR) and type 2 diabetes mellitus(TIDM). AD and diabetes have good correlation and similarity. Probiotics,prebiotics and Chinese herbal medicines can rebuild GM and have been reported to ameliorate the memory loss of AD patients or model rats. However ,whether and how their preventative and therapeutic effects on AD mediated by GM are worthy of further investigation.

Objective To investigate the awareness and trainning needs of health management knowledge in primary healthcare professionals in Beijing.Methods Six hundred primary healthcare staff from Daxing,Fangshan,Miyun,Pinggu and Huairou District of Beijing were selected in 2012 through muhiphase random sampling method and required to complete a standardized questionnaire.The survey included the average awareness rates of health management(tobacco,body weight and alcohol consumption control and daily physical exercises),the rates of application and conception awareness of risk assessment tools of chronic diseases,the awareness rates of normal levels of blood pressure and serum glucose as well as training needs.Differences in different regions were analyzed.Chi-square test was used for data analysis.Results The average awareness rates of tobacco,body weight and alcohol consumption control and daily physical exercises were 94.1％ (513/545),95.3％ (522/548),94.0％ (515/548) and 85.9％ (470/547),respectively.However,the rates of application and conception awareness of risk assessment tools of chronic diseases were only 55.1％ (295/535) and 59.8％ (329/550),respectively.Those who knew the normal levels of blood pressure and serum glucose accounted for 85.4％ (475/556) and 92.4％ (514/556),respectively; although only 23.6％ (131/556) and 21.2％ (118/556) were completely familiar with the major risks of these conditions.About 57.4％ (308/537) or 56.7％ (305/538) participants reported urgent needs for health education on diabetes and hypertension management.Conclusion The awareness of health management of primary healthcare professionals in rural areas of Beijing remains lower and may need to be raised by education or training.

Objective To evaluate thetherapeutic effect of sodium deoxyribonucleotide injection at Zusanli point for chemotherapy-induced leukopenia in patients with lung cancer.MethodsA total of 116 chemotherapy-induced leukopenia patients with lung cancer were randomly divided into a therapy group and a control group, 60 in the treatment group and 56 in the control group. The patients in the treatment group were treated with sodium deoxyribonucleotide injection atZusnlipoint, and those in the control group were treated with vein injection of sodium deoxyribonucleotide.Results The total effective rate in the treatment group was significant higher than that in the control group (91.7%vs.76.8%;χ2=4.890,P=0.032). The effective rates on days 3,5,7 and 10 in the treatment group were also significant higher than those in the control group (on day 3: 51.7%vs. 32.1%,χ2=4.530,P=0.036; on day 5: 76.7%vs. 53.6%,χ2=6.840,P=0.018; on day 7: 85.0%vs. 67.9%,χ2=4.770,P=0.026; on day 10: 78.3%vs. 53.6%,χ2=7.960,P=0.011).Conclusion Sodium deoxyribonucleotide injection atZusanlipoint has definite efficacy for chemotherapy-induced leukopenia in patients with lung cancer.

Objective To investigate the treatment methods of tissue defects in nose and lower eyelid area.Methods Based on the impaired area,combined pre-expansion of forehead and facial region was adopted.The volume of soft tissue expander was determined.150-170 ml expander was implanted between frontalis muscle and periosteum of forehead,while at the facial region,and the volume of expander should be determined by the normal skin area as large as possible.The excision of impaired tissue was performed after sufficient expansion,and then skin flap or transposition skin flap were advanced at the facial region.At forehead,ortho-position skin flap based on supratrochlear vessels was designed for repairing the nose and palpebra inferior region.Three weeks later division of the ortho-position skin flap was carried out.With the flattened pedicle,the rest part of impaired area was replaced.Results Six cases were performed with this method.For all the cases,the survival rate of flap was 100％.Esthetic appearance and satisfying color-match were achieved,without appearance of lower eyelid ectropion.Conclusions Combined pre-expansion of forehead and facial region is an ideal method in treatment of the defects in nose and lower eyelid area.

OBJECTIVE:To study the immunosuppressive chemical constituents from the n-butanol extract of the debark root of Tripterygium wilfordii hook.f.METHODS:Several compounds were isolated from the n-butanol extract by columns of silica gels and Sephadex LH-20,their structures were identified by NMR,MS spectral analysis and comparing with standard substances on TLC,and the immunosuppressive activity was determined.RESULTS:One of the compounds was identified as emodin,an anthraquinone,it had marked immunosuppressive effect on animal.CONCLUSION:Emodin is obtained from the plants of Tripterygium wilfordii hook.f.for the first time.