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

OBJECTIVE:To make an investigation on the quality of decoctions of traditional Chinese medicine prepared by decocting device and fire heating decocting method.METHODS:To compare the chemical compositions in decoctions of Salvia miltiorrhiza Bunge prepared by above-mentioned two methods and to take the contents of danshensu and protocatechualdehyde as indices,both of which were determined by HPLC.RESULTS:There were no evident difference between the two methods in extracting chemical compositions.In addition,the contents of danshensu and protocatechualdehyde prepared by decocting device were as2.97times and5.6times as those prepared by fire heating decocting method respectively.CONCLUSION:The prepa?ration of decoction of Saliva miltiorrhiza Bunge by decocting device can double the effective constituents.This provides scien?tific basis for making rational use of herbs.

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.

Objective To detect the expression of E-cadherin and ?-catenin in breast carcinoma and analyze the relationship between E-cadherin and ?-catenin and the clinicopathological features. Methods The expression of E-cadherin and ?-catenin in breast cancer, paracarcinoma breast tissue, simple mastoplasia and atypical mastoplasia were detected by immunohistochemical method and the results were compared. Results The abnormal expression rates of E-cadherin and ?-catenin in breast cancer tissue were 51.9% and 61.1 %,respectively. Abnormal expression of E-cadherin was significantly correlated with histological grade. Abnormal expression of ?-catenin was significantly correlated with TNM staging, axillary lymph nodes metastasis and postoperative distant metastasis. COX multiple factor analysis showed that neither E-cadherin nor ?-catenin expression was an independent indicator for the prognosis of breast cancer. Conclusions Abnormal expressions of E-cadherin and ?-catenin are correlated with occurrence and development of breast carcinoma. Abnormal expressions of E-cadherin and ?-catenin are good indicators to judge invasion and metastasis of breast carcinoma.

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 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 effect of propofol anesthesia on stress response and immune function of laproscopic cholecystectomy.Methods Corticosterone,glucose,complement concentrations in plasma of 20 ASAⅠ～Ⅱ patients under propofol combined anesthesia undergoing elective laproscopic cholecystectomy,were respectively determined before anesthesia,operation,gallbladder ablation and after de-intubation.Results After anesthesia,blood glucose increased while C3 and CH50 decreased gradually(P

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 .

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 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.