Objective To evaluate the implication and necessity of deepithelialization in mastopexy.Methods A total of 124 patients with mastoptosis were randomly divided into 2 groups:group Ⅰ and group Ⅱ,62 cases each.A double-circle incision technique was used for all the patients.In group Ⅰ,full thickness skin around nipple-areola was resected.While in group Ⅱ,deepithelialization was performed and the peri nipple-areola dermis was preserved.Results The average full skin resection time was 4.5 minute per side in group Ⅰ and the skin deepithelialization time was 15.8 minute per side in group Ⅱ.Postoperative follow-up was carried out for all the 124 patients with duration of 2 weeks to 4 years.In group Ⅱ,sebaceous cysts,epidermal inclusion cyst and suture knot exclusion were found at the incision site in 8 patients (12.9 ％) at 3 weeks to 1.5 years after operation.Conclusions The blood supply to the nipple-areola complex is not affected by full-thickness skin removal during mastopexy,while the incidence of complication at the incision site decreases significantly.We conclude that deepithelialization has not much clinical significance in mastopexy.

Objective To investigate the current status of hand hygiene(HH) among health care workers(HCWs) in clinical laboratories in medical institutions in Xi'an City.Methods HH status of HCWs in clinical laboratories in medical institutions in Xi'an was performed random on-the-spot sampling and monitoring.Results A total of 240 HH specimens of HCWs in clinical laboratories in 80 medical institutions in Xi'an City were collected, 127 detected results were qualified, the total qualified rate was 52.92%.The qualified rates of medical institutions were as follows: municipal hospitals 62.67%,workers' hospitals 55.95%,private hospitals 40.74%;comprehensive medical institutions 67.68%,specialized medical institutions 42.55%;tertiary medical institutions 79.63%(n=43),secondary and below medical institutions 45.16%(n=84),there were significant differences in HH qualified rate among HCWs in different types of medical institutions(all P<0.01).Of different HH detection items, detection rates of Escherichia coli and Staphylococcus aureus were 0.83% and 8.33% respectively.There were significant differences in HH compliance rates among HCWs of all age groups(χ2=9.103,P<0.05), HCWs aged≥50 years had the highest qualified rate of HH(71.43%), followed by those aged<30 years (67.82%),HCWs in 40~ year age group had the lowest HH qualified rate (39.66%).Conclusion The qualified rate of HH of HCWs in clinical laboratory of medical institutions in Xi'an City is low, it is necessary to enhance the procaution awareness of HCWs in clinical laboratories, strengthen quality control of HH, strictly implement standard hand-washing procedures to reduce occurrence of HAI.

OBJECTIVETo investigate the effect of ischemic preconditioning on chaperone hsp70 expression and protein aggregation in the CA1 neurons of rats, and to further explore its potential neuroprotective mechanism.

METHODSTwo-vesseloccluded transient global ischemia rat model was used. The rats were divided into sublethal 3-min ischemia group, lethal 10-min ischemia group and ischemic preconditioning group. Neuronal death in the CA1 region was observed by hematoxylineosin staining, and number of live neurons was assessed by cell counting under a light microscope. Immunochemistry and laser scanning confocal microscopy were used to observe the distribution of chaperone hsp70 in the CA1 neurons. Differential centrifuge was used to isolate cytosol, nucleus and protein aggregates fractions. Western blot was used to analyze the quantitative alterations of protein aggregates and inducible chaperone hsp70 in cellular fractions and in protein aggregates under different ischemic conditions.

RESULTSHistological examination showed that ischemic preconditioning significantly reduced delayed neuronal death in the hippocampus CA1 region (P < 0.01 vs 10-min ischemia group). Sublethal ischemic preconditioning induced chaperone hsp70 expression in the CA1 neurons after 24 h reperfusion following 10-min ischemia. Induced-hsp70 combined with the abnormal proteins produced during the secondary lethal 10-min ischemia and inhibited the formation of cytotoxic protein aggregates (P < 0.01 vs 10-min ischemia group).

CONCLUSIONIschemic preconditioning induced chaperone hsp70 expression and inhibited protein aggregates formation in the CA1 neurons when suffered secondary lethal ischemia, which may protect neurons from death.

Animals ; Brain Ischemia ; pathology ; Cell Count ; methods ; Cell Death ; Disease Models, Animal ; Gene Expression Regulation ; physiology ; HSP70 Heat-Shock Proteins ; metabolism ; Hippocampus ; blood supply ; metabolism ; pathology ; Ischemic Preconditioning ; Male ; Neurons ; metabolism ; Proteins ; metabolism ; Rats ; Rats, Wistar ; Time Factors

Cannula ; Catheters ; Drainage ; Duodenal Diseases ; Humans ; Intestinal Fistula/surgery*

OBJECTIVETo study the tissue culture and rapid-proliferation techniques of Pueraria mirifica.

METHODThe tender branch were used as explants and cultivated in different media. The optimum media for inducing buds, proliferation and rooting were selected by adjusting the kinds and doses of plant hormones and special compounds.

RESULTThe medium of MS + IBA 0.05 mg L(-1) + BA 0.5 mg L(-1) was suitable for buds inducing and could be used in the first generation cultivation; MS + IBA 0. 02 mg L(-1) + BA 0.2 mg L(-1) and MS +BA 0.1 mg L(-1) were employed by turns in subculture, 25 days propagation coefficient was 3.0; and the medium of 1/2MS + IBA 0.1 mg L(-1) + IAA 0.2 mg L(-1) + C (special compound) 10 mg L(-1) was used for roots inducing, the rooting rate was 76.9%. Rooting plantlets were transplanted in spring and summer; the surviving rate was 81.0%.

CONCLUSIONThis technique system could be employed for rapid propagation of P. mirifica.

Pueraria ; growth & development ; Tissue Culture Techniques ; methods

OBJECTIVETo detect lymphangiogenesis by labeling the lymphatic endothelial marker, lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1), and study the prognostic relevance of lymphangiogenesis in laryngeal squamous carcinoma.

METHODSClinical files and specimens of 78 patients with histologically diagnosed laryngeal carcinoma were stained with LYVE-1 as a specific lymphatic endothelial marker. The lymphatic vessel density (LVD) was measured, and the correlation between LVD and clinicopathological features of the tumor cases was analyzed.

RESULTSThe mean LVD in laryngeal carcinoma (13.24 ± 5.09) was significantly higher than that in adult laryngeal papilloma (5.54 ± 3.15) and squamous dysplasia (6.76 ± 4.45, P < 0.05). The LVD of poorly differentiated tumors (15.74 ± 5.24) was significantly higher than that in the moderately differentiated tumors (13.84 ± 6.20), and the LVD in the moderately differentiated tumors was significantly higher than that in the well-differentiated tumors (11.68 ± 6.34). The LVD in stage 0 to stage II group (10.66 ± 5.70) was significantly lower than that in the stage III to IV group (17.01 ± 6.35). The lymph node metastasis group (17.25 ± 7.37) was significantly higher than non-lymph node metastasis group (8.60 ± 5.23, P < 0.05). There was no significant association between LVD and age, sex, primary site and distant metastasis. The overall survival in the patients with a LVD higher than the mean value was 33.5 month, and that of cases with a LVD lower than the mean value was 81.6 month (P < 0.05). The multivariate survival analysis showed that the clinical stage and LVD were independent prognostic factors of laryngeal cancer.

CONCLUSIONSThe LYVE-1 staining histochemistry demonstrates that the lymphangiogenesis occurrs mainly at the edge of the tumors, and lymphangiogenesis plays an important role in the carcinogenesis, cancer progression and lymph node metastasis in laryngeal cancer. LVD may be an independent indicator of poor prognosis of laryngeal cancer.

Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Papilloma ; metabolism ; pathology ; Precancerous Conditions ; metabolism ; pathology ; Survival Rate ; Vesicular Transport Proteins ; metabolism

Objective To present the clinical effect of the delayed tissue expanding breast reconstruction with implants.Methods For those who received breast tumor surgeries,round-shaped expander was implanted for increasing skin coverage and silicone implant was used for breast reconstruction after several months' expanding.Results 15 relevant cases were included in this study with an average of 5.1 months expanding period.Only one patient received reoperation for capsular contracture and there was no complication in the other cases.Conclusions Delayed tissue expanding breast reconstruction with implants,with a wide indication,is an ideal reconstructive method which can reduce the interference of tumor recurrence and radiotherapy and avoid the trauma of donor site and the patch-like appearance of breast.

Objective To investigate the application of liposuction in refining the dog-ear deformity following autologous flap breast reconstruction.Methods Between May 2012 and September 2016,16 patients with dog-ear deformity in the donor site following autologous flap breast reconstruction were treated with liposuction.All the patients were female with an average age of 40.6 years (range,32-47 years).After the operational compression garment was used for at least one month.Regular follow-up was performed after the above operation.Results The follow-up period lasted for 6 to 8 months.The dog-ear deformity was restored to normal appearance.All cases achieved satisfactory results without complications such as local depression,infection,skin necrosis etc.Conclusions For some of the dog-ear deformity following autologous flap breast reconstruction,liposuction is a good and simple method without adjuvant incisions.

Objective: To evaluate the safety, reliability and effectiveness of "free style endoscopic technique" assisted transaxillary high level dual plane breast augmentation; To explore endoscopic techniques that can achieve higher efficiency and better result ; To discover a safe and effective method for dual plane dissection with the help of endoscopy. Methods: Using new endoscopic techniques to perform transaxillary dual plane breast augmentation: ① High level dual plane technique, the muscle division line is about 1.5 cm higher than the original inferior mammary fold, the cephalic side of the muscle is retracted to the lower border of the areola with a special retractor to form a high level dual plane cavity, thus the upper and lower portion of the implant would be covered by pectorilis major muscle, while the rest of the implant was partially under breast parenchyma. ② "Free style endoscopic techniques" , the endoscopy and retractor are not fixed to each other, thus the space is exposed by an assistant with a new designed special retractor, while the operator is concentrate on dissecting with endoscopy in one hand and long tipped bowie in the other hand. ③ Accurate navigate technique, define the dissection border by acupuncture via skin in a 90 degree angle, thus to make the dissection right as preoperative design. Results: There were 1 106 cases underwent this kind of surgery, while 405 of them, whose minimum follow up were 12 months were included in this retrospective study. The follow up period ranged from 12-60 months, the average follow up period is 24.3 months. The average operation time is (1.47 ±0.46) h, the average drainage removal time is (4.23±0.51) d after surgery. The perioperative complication rate is 0.99%, including an incision site change caused by intraoperative bleeding, 1 case of pneumothorax, 2 cases of bleeding after surgery. Long period complication including: 6 cases (1.48%) Ⅲ grade capsular contracture, 21 cases (5.20%) of nipple-areola sensation disorders, implant palpable occurred in 14 case (3.46%), 3 cases (0.74%) implant malposition, 2 cases (0.49%) implant distortion, the total reoperation rate is 2.47%. There was no infection, hematoma, seroma, curtain deformity, double bubble deformity occurred in our study. Conclusions The high level dual plane techniques not only can solve the deficient soft tissue coverage problem thus to lower the rate of implant palpability, but also can relieve the relationship of the pectorilis major muscle and the inframammary fold(IMF), offering an option to replace Ⅱ and Ⅲ type of dual plane techniques, decrease the risk of curtain deformity and double bubble deformity. The free style endoscopic techniques are very flexible and efficient, with the help of accurate navigate technique, it can archive an accurate cavity dissection, accurate and definite IMF, and a lower complication rate. Though the learning curve is relatively longer, it is really a safe and effective breast augmentation method worthwhile to learn and spread.

Objective: To investigate the application and therapeutic effect of external tissue expansion-assisted autologous fat grafting for delayed breast reconstruction. Methods: Patients began wearing the BRAVA negative pressure system 8 hours a day for recipient tissue expansion for one month before the fat grafting procedure. After fat grafting, BRAVA was recommended to be worn 8 hours a day from postoperative 48 hours to one month. The interval of each fat grafting procedure was 2.5 to 3.0 months. The procedures were repeated until the completion of breast reconstruction. Water-jet assisted liposuction and subcutaneous release of scars were also performed during surgery. Results: From January 2013 to November 2016, 29 patients were followed up for 12 to 58 months, with average of 31.6 months. 28 patients completed the external tissue expansion-assisted autologous fat grafting breast reconstruction. Completion required 1 to 6 procedures, with average of 3.4 procedures. The total initial fat fill volume for each breast was ranged from 200 to 1 000 ml, with average of 583.7 ml. The initial fat fill volume for each breast was ranged from 92.5 to 243.7 ml per operation, with average of 173.8 ml. One patient underwent latissimus dorsi myocutaneous flap breast reconstruction after 3 fat grafting procedures. 8 patients completed the inframammary fold reconstruction, 3 patients underwent breast lift, 1 patient underwent lipofilling augmentation for the contralateral side. Postoperative satisfaction rate was 82.8% in patients and 75.9% in surgeon. Complication statistics: 5 cases of palpable nodules which recognized as fat necrosis (17.2%), one case of nontuberculous mycobacterial infection (3.4%) and one case of locoregional cancer recurrence (3.4%). Conclusions External tissue expansion-assisted autologous fat grafting is a minimally invasive procedure for breast reconstruction. Satisfactory results could be obtained for most of the patients who would like to choose fat grafting and have enough fat deposit in other parts of the body.