OBJECTIVETo investigate the clinical application of free superficial iliac circumflex artery skin flaps, as well as the management of donor site defects.

METHODS17 free superficial iliac circumflex artery skin flaps were applied for the traumatic defects or deformities on face, neck, foot, hand, ankle and lower leg, respectively. The donor site defects were closed directly or covered by paraumbilical island flaps.

RESULTSThe 17 flap size ranged from 5 cm x 3 cm to 19 cm x 14 cm. 16 flaps survived completely except 1 flap with partial necrosis, which was closed by free skin graft. The donor site defects were closed directly in 10 cases, and covered by paraumbilical island flaps in 7 flaps without no flap necrosis. The abdomen had a good appearance.

CONCLUSIONSGood appearance can be achieved with free superficial iliac circumflex artery skin flaps for the defects on face, neck, foot, hand, ankle and lower leg. Paraumbilical island flap can be used for the donor site defects.

Arteries ; Foot ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Skin ; Skin Transplantation ; Transplant Donor Site ; surgery ; Wounds and Injuries ; surgery

BACKGROUND: Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic. To a certain extent, it has altered the way sporting activities operate. There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic. This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20, 2022. METHODS: We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic, medical venues, and ambulance. We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training, respectively, with incidence presented as injuries/illnesses per 100 athlete-days. RESULTS: In total, 2,897 athletes from 91 nations experienced injury or illness. Beijing 2022 medical staff reported 326 injuries and 80 illnesses, equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period. Altogether, 11% of the athletes incurred at least one injury and nearly 3% incurred at least one illness. The number of injured athletes was highest in the skating sports (n=104), followed by alpine skiing (n=53), ice track (n=37), freestyle skiing (n=36), and ice hockey (n=35), and was the lowest in the Nordic skiing disciplines (n=20). Of the 326 injuries, 14 (4.3%) led to an estimated absence from training or competition of more than 1 week. A total of 52 injured athletes were transferred to hospitals for further care. The number of athletes with illness (n=80) was the highest for skating (n=33) and Nordic skiing (n=22). A total of 50 illnesses (62.5%) were admitted to the department of dentistry/ophthalmology/otolaryngology, and the most common cause of illness was other causes, including preexisting illness and medicine (n=52, 65%). CONCLUSION: Overall, 11% of athletes incurred at least one injury during the Games, which is similar to the findings during the Olympic Winter Games in 2014 and 2018. Regarding illness, 2% of athletes were affected, which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

OBJECTIVESTo investigate a new targeting mechanical arm for CT-based navigated percutaneous fixation of pelvic fractures, and to evaluate the safety and efficiency of the procedures.

METHODSUsing CT-based 3D navigation software combined with targeting mechanical arm, percutaneous insertion of pelvic models (3 dry human cadaver pelvic skeletons and 5 plastic Sybone pelvic models) were performed, 8 pelvic models allowed percutaneous cannulated screw insertion of both S-I joint (2 S-I screws placement for each side, total 32 screws in this experiment) and both superior ramus (1 ramus medullary screw placement for each side, total 16 screws in this experiment). Percutaneous insertion of pelvic models (4 dry human cadaver pelvic skeletons and 4 plastic Sybone pelvic models, 1 S-I screws and 1 ramus medullary scre placement for each side, 32 screws in this experiment) were performed using fluoro-navigation system (Stryker, USA). Time necessary for every screw insertion were recorded. Accuracy of screw placement was assessed using C-arm imaging and direct eyes inspecting. The time and accuracy of the two methods were compared.

RESULTSThe time required for the CT-based 3D navigation procedure (3.6 ± 1.2) min was significantly less than using the targeting mechanical arm compared to drilling freehand with navigation (9.1 ± 0.8) min (t = 2.50, P < 0.01). There was no significant difference in accuracy between the two methods.

CONCLUSIONCT-based 3D navigation software combined with targeting mechanical arm should be potential to apply percutaneous sacroiliac screwing for pelvic fractures with more accurate and more reliable.

Bone Screws ; Cadaver ; Fracture Fixation, Internal ; methods ; Humans ; Models, Anatomic ; Pelvic Bones ; surgery ; Software ; Surgery, Computer-Assisted ; methods

OBJECTIVETo summarize experiences of serious perioperative complications management of obstructive sleep apnea hypopnea syndrome (OSAHS), and evaluate the effect of intervention in decreasing the incidence of serious complications.

METHODSRetrospective analysis of clinical data in Shenyang General Hospital of PLA and Liaoning Province Jinqiu Hospital of OSAHS surgery cases from January 1995 to December 2009 were included in this study, patients were divided into two groups according to with or without intervention. Experience and lessons were analyzed.

RESULTSPatients without and with intervention were 402 and 521 respectively, and uvulopalatopharyngoplasty (UPPP) cases in each group were 387 and 390. Five patients in the first group who accepted UPPP had breathing difficulty and were all successfully rescued, while no one in the second group had breathing difficulty. The difference was significant (P < 0.05). Sixteen patients in the first group had severe bleeding after UPPP, while only 5 patients had the severe bleeding in the second group. The difference was significant, too P < 0.05. No breathing difficulty cases in the second group, and serious bleeding cases in each group was 5 and in 1, there was no significant difference (P > 0.05).

CONCLUSIONSBreath difficulty and serious bleeding are serious perioperative complications of OSAHS surgery, and with systemic intervention the incidence of the complications can be decreased.

Adolescent ; Adult ; Aged ; Female ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Middle Aged ; Palate, Soft ; surgery ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery ; Young Adult

OBJECTIVETo evaluate the effect of hypoxia-inducible factor-1 alpha (HIF-la) on angiogenesis in human prostate cancer cells.

METHODSHuman prostate cancer cells of the line LNCaP were cultured and transfected by the recombinant plasmid pcDNA3. 1(-)/HIF-1alpha containing the gene HIF-1alpha with the Lipofectamine 2000 system. The positive clone cells were selected by G418 and confirmed by Western blotting and immunofluorescence (LNCaP/HIF-1alpha cells). The expressions of VEGF, iNOS and Ang-2 were detected by Western blotting.

RESULTSThe expression of HIF-1alpha in the LNCaP/HIF-1alpha cells was distinctly higher than that in the LN-CaP cells. Compared with the LNCaP cells, the expressions of VEGF and iNOS were up-regulated, whereas Ang-2 remained unchanged in the LNCaP/HIF-1alpha cells.

CONCLUSIONThe over-expression of HIF-1alpha can induce an increase in angiogenesis proteins and improve the angiogenesis potency of prostate cancer.

Blotting, Western ; Cell Line, Tumor ; Fluorescent Antibody Technique ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Lipids ; chemistry ; Male ; Nitric Oxide Synthase ; metabolism ; Plasmids ; chemistry ; genetics ; Prostatic Neoplasms ; blood supply ; metabolism ; pathology ; Transfection ; methods ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo analyze the impact of efforts of community-based organizations (CBO) in HIV testing mobilization and case finding among men who have sex with men(MSM).

METHODSResults of HIV testing mobilization among MSM through CBOs in 15 program areas were collected and compared with corresponding HIV case reporting data to demonstrate the contribution of CBO-based HIV testing in HIV case finding among MSM from July 2008 to December 2011. Meanwhile,the proportion of screened HIV positives who received testing results notification,confirmatory test, following up and CD4 cell tests were analyzed and compared with those identified in medical institutions.

RESULTSA total of 196 075 HIV tests were performed for MSM, as a result of mobilization efforts of CBOs. Cumulatively 7704 new HIV cases were identified, accounting for 51.7% (7704/14 914) of all newly diagnosed HIV cases infected via homosexual sex in the program areas.Among the newly diagnosed MSM HIV infections in the program areas,the proportion of infections detected through the mobilization of CBOs increased from 35.4% (609/1722) in 2008 to 63.7% (2371/3722) in 2010, and 58.3% (3024/5189) in 2011. Compared with those identified through medical institutions, newly diagnosed MSM infections detected though CBOs testing mobilization have higher rates of receiving screening testing results notification (97.3% (4441/4563) vs 92.8% (13 140/14 153)) , (84.6% (2559/3024) vs 79.8% (5589/7002)) and CD4 cell tests (66.1% (1999/3024) vs 52.9% (3705/7002)), and a lower rate of receiving confirmatory test (78.6% (3588/4563) vs 85.6% (12 115/14 153)).

CONCLUSIONCBOs can take their advantages in mobilizing MSM to receive HIV test, and MSM HIV cases detected through CBOs have become the main source of MSM HIV case finding in program areas.

Community Health Services ; HIV Infections ; prevention & control ; HIV Seropositivity ; Health Promotion ; Homosexuality, Male ; Humans ; Male ; Mass Screening

BACKGROUNDThe pathological abnormalities of the AIDS patients lie in the subcortical regions of the brain, specifically the deep white matter and basal ganglia, while the extent of pathology generally correlates with the severity of cognitive impairments in the white matter and basal ganglia. Brain metabolite changes of these lesions can reflect the pathological abnormalities. The purpose of this study was to assess the value of magnetic resonance spectroscopy (MRS) in the diagnosis of cognitive impairment in AIDS patients.

METHODS3.0T MR was used to measure N-acetyl aspartate (NAA), choline (Cho), myo-inositol (MI) and creatinine (Cr) in the frontal white matter, basal ganglia and parietal cortex of 21 AIDS patients with dementia complex (ADC), 19 AIDS patients with neuroasymptomatic (NAS) and 20 seronegative (SN) controls. Then we compared the difference of metabolic rate between AIDS patients and SN groups.

RESULTSNAA/Cr (mean = 1.2502, SD = 0.1600) was significantly decreased and Cho/Cr (mean = 1.2028, SD = 1.1655) was increased in the frontal white matter in ADC group, while NAA/Cr (mean = 1.5334, SD = 0.0513) was reduced in NAS group when compared with SN group. NAA/Cr in the basal ganglia was decreased in both ADC and NAS groups (mean = 1.2625, SD = 0.1615 and mean = 1.5278, SD = 0.0380, respectively). Cho/Cr (mean = 1.1631, SD = 0.0981) was markedly increased in ADC group. Although NAA/Cr, Cho/Cr and MI/Cr in the parietal cortex had a certain change in both ADC and NAS groups compared with SN group, the differences were not statistically significant.

CONCLUSIONSThe brain metabolite changes of AIDS patients are correlated with cognitive impairments. MRS can be used as a valuable inspection method to assess cognitive impairments in AIDS patients.

Acquired Immunodeficiency Syndrome ; physiopathology ; Adolescent ; Adult ; Cognition Disorders ; diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Young Adult

BACKGROUND: The size of artificial disc is not exactly identical to cervical vertebral endplate. However, the effect of implant size on cervical disc replacement has not yet been clearly identified. OBJECTIVE: To evaluate the effect of Bryan disc size on cervical artificial disc replacement. METHODS: Totally 71 patients with cervical degenerative disease underwent single-level Bryan disc replacement from December 2003 to December 2007 were enrolled. The average age was (45.90±8.12) years old, and all patients were followed up for more than 10 years. The artificial disc size was measured using lateral X-ray films, and expressed as (Bryan artificial disc's footprint sagittal diameter×2) / (upper endplate sagittal diameter + lower endplate's sagittal diameter)×100%. X-ray films were photographed to measure motion range of the treated segment before surgery, 3 months after surgery, and during final follow-up. Clinical outcomes, including Japanese Orthopaedic Association score, Neck Disability Index and Odom's scores, were evaluated before and after operation. Observational indexes of different disc sizes (≥95% and <95% groups) were compared and analyzed. RESULTS AND CONCLUSION: (1) There were 49 patients in the ≥95% group and 22 patients in the <95% group. (2) At 3-month follow-up, range of motion was significantly smaller in the <95% group than in the ≥95% group (P < 0.01). At the final follow-up, range of motion was significantly smaller in the <95% group than in the ≥95% group (P < 0.05). (3) At final follow-up, improvement rate of Japanese Orthopaedic Association score was (70.65±32.58)% in the <95% group and (68.83±38.85)% in the ≥95% group, and no significant difference was detected between the two groups (P > 0.05). (4) At final follow-up, Neck Disability Index decreased by (10.82±7.50)% in the <95% group, and (12.61±8.51)% in the ≥95% group, and no significant difference was detected between the two groups (P > 0.05). (5) At final follow-up, Odem's score results showed excellent in 10 cases (45%), good in 9 cases (41%) and average in 3 cases (14%) in the <95% group; and excellent in 26 cases (53%), good in 20 cases (41%) and average in 3 cases (6%) in the ≥95% group, and no significant difference was detected between the two groups (P > 0.05). (6) Results suggest that different sizes of artificial disc replacement have obtained good functional recovery, but small artificial disc may impact the range of motion. We should try to avoid placing the artificial disc smaller than 95%.

Objective To observe the anatomic and imaging morphology ofjugnlar bulb and its relationship with the surrounding structures, and to investigate the classification ofjugnlar bulb and its clinical significance. Methods We dissected 30 human temporal bones and studied multi-slice spiral CT imaging data of temporal bone of 120 cases and blood vessel cast mould specimen of the jugular bulb of 6 cases, to observe the morphology of jugnlar bulb and its spatial relationship with the surrounding structures. We made an imagined sagittal plane on the medial well of the tympanic cavity, with a horizontal tangent line of the proximal wall of the tympanic cavity and a vertical tangent line of the posterior wall of the tympanic cavity as coordinate axes (X axis and Y axis), respectively, so the 4 quadrants ( Ⅰ , Ⅱ, Ⅳ, Ⅳ) were formed. The jugular bulb was classified intro 4 types according to the quadrant where its top was projected and subtyped according to its position on the inner or outer side of the plane. The operation via mastoid approach was simulated on specimen to observe the effect of jugnlar bulb on the operation route. Results Some jugular bulbs were flat type and others were prominent types. The classification in the group of CT image: type Ⅰ , 11 case (9%);type Ⅱ, 63 cases (53%);type Ⅲ, 25 cases (21%);type Ⅳ, 21cases (17%). The classification in the group of specimen: type Ⅰ, 1 case (3%);type Ⅱ, 11 cases (37%);type Ⅲ, 8 cases (27%);type Ⅳ, 10 cases (33%). Each type of the jugular bulb had different effects on the operative approach. Conclusions The classification method with the 4 quadrants is a simple and three-dimensional way to describe the position of the jugular bulb for imaging diagnosis or operative scheme design.

[Abstract] Objective To explore the effect of different modes of blood flow shear stress on the Pim1 expression in human umbilical vein endothelial cells (HUVECs) and the regulation of phosphorylation at Ser1177 and Ser633 of endothelial nitric oxide synthase (eNOS). Methods HUVECs were isolated from fresh human umbilical cord. The parallel plate flow chamber system was used to load 15 dyn/ cm