OBJECTIVETo introduce the application of "tennis racket" flap with fascial pedicle on the healthy chest for radiation ulcer after surgical treatment of breast cancer.

METHODSThe " tennis racket" flap was designed on the healthy chest along the cartilage with fascia pedicle near the sternum. 9 cases were treated. The flaps size ranged from 5.0 cm x 3.5 cm to 13 cm x 11 cm with pedicle size of 2-8 cm in length and 2.0-3.0 cm in width.

RESULTSAll the 9 flaps survived completely with satisfactory appearance. The patients were followed up for 2 months to 3 years without ulcer reoccurrence.

CONCLUSIONSThe "tennis racket" flap has a slender fascial pedicle without major blood vessel. It has the advantages of good flexibility for rotation and large flap size for the reconstruction of the radiation ulcer after surgical treatment of breast cancer.

Breast Neoplasms ; radiotherapy ; Fascia ; Female ; Humans ; Radiodermatitis ; surgery ; Skin Ulcer ; etiology ; surgery ; Sternum ; Surgical Flaps ; Tennis

OBJECTIVETo study the changes in biological behaviors of meningitis E. coli K1 strain E44 after deletion of polyphosphate kinase 1 (ppk1) gene and explore the role of ppk1 in the pathogenesis of E. coli K1-induced meningitis.

METHODSThe wild-type strain E. coli K1 and ppk1 deletion mutant were exposed to heat at 56 degrees celsius; for 6 min, and their survival rates were determined. The adhesion and invasion of the bacteria to human brain microvascular endothelial cells (HBMECs) were observed using electron microscopy and quantitative tests. HBMECs were co-incubated with wild-type strain or ppk1 deletion mutant, and the cytoskeleton rearrangement was observed under laser scanning confocal microscope.

RESULTSThe survival rate of the ppk1 deletion mutant was significantly lower than that of the wild-type strain after heat exposure. The ppk1 deletion mutant also showed lowered cell adhesion and invasion abilities and weakened ability to induce cytoskeleton rearrangement in HBMECs.

CONCLUSIONSppk1 gene is important for E.coli K1 for heat resistance, cell adhesion and invasion, and for inducing cytoskeletal rearrangement in HBMECs.

Brain ; cytology ; Cells, Cultured ; Cytoskeleton ; Endothelial Cells ; cytology ; microbiology ; Escherichia coli ; genetics ; physiology ; Escherichia coli Proteins ; genetics ; Gene Deletion ; Humans ; Phosphotransferases (Phosphate Group Acceptor) ; genetics

Objective To explore the beneficial effects and mechanisms of neutrophil elastase (NE) and myeloperoxidase (MPO) on lead-induced hepatic inflammation in mice. Methods The specific pathogen free male C57BL/6 mice were randomly divided into four groups： control group, lead-exposed group, NE inhibitor group, and MPO inhibitor group, with three mice in each group. The mice in lead-exposed group, NE inhibitor group, and MPO inhibitor group were intraperitoneally injected with a dose of 10 mg/kg body mass of lead acetate solution, while the mice of control group received an equal volume of 0.9% saline three times per week for four weeks. In the last seven days, mice in both inhibitor groups were intraperitoneally injected with a dose of 40 mg/kg NE inhibitor sivelestat sodium or MPO inhibitor 4-aminobenzoic acid hydrazide (4-ABAH) once per day. Mouse body weight and liver histopathological changes were observed. The mRNA expression of genes associated with inflammation, such as tumor necrosis factor-α (Tnfa), interleukin-1β (Il1b), interleukin-6 (Il6), and nucleotide-binding oligomerization domain-like receptor protein 3(Nlrp3), apoptosis-associated speck-like protein (Asc) and cysteinyl aspartate specific proteinase (Caspase1) in the mouse liver tissues was detected by real-time quantitative polymerase chain reaction. The protein expression of NLRP3, ASC, and CASPASE-1 was detected using Western blotting. Results The activities of mice in all four groups were generally normal, and there was no significant difference in body weight (P>0.05). The results of hematoxylin-eosin staining showed that the cell size of hepatocytes varied in the lead-exposed mice, with indistinct cell boundaries, indicating early inflammatory responses in liver tissues. After intervention with NE or MPO inhibitors, the early inflammatory responses improved in the liver tissues of the mice in both inhibitor groups, with a better improvement observed in MPO inhibitor group compared with the NE inhibitor group. The mRNA expression of Tnfa, Il1b, Il6, Nlrp3, Asc, and Caspase1, as well as the protein expression of ASC, and CASPASE-1 in the livers of mice in the lead-exposed group was higher compared with those in the control group (all P<0.05). Compared with the lead-exposed group, the relative mRNA expression of Tnfa, Il1b, Il6, Nlrp3 and Asc was decreased in the liver tissues of mice in the NE inhibitor group (all P<0.05), while the relative expression of mRNA of Tnfa, Il1b, Il6, Caspase1 and the protein expression of ASC and CASPASE-1 were decreased in the liver tissues of mice in the MPO inhibitor group (all P<0.05). Conclusion Lead induce hepatic inflammation in mice by activating NLRP3 inflammasome. The inhibition of NE or MPO improve the lead-induced hepatic inflammatory responses in mice by alleviating NLRP3 inflammasome activation.

Objective To study the value of free-style perforator flap in repairing nasal defects after tumor resection.Methods On the basis of the guidance of free-style perforator flap design concept and the foundation of vascular localization by Doppler based on the ultrasonic echo intensity,combined with nasal beauty subunits,we designed free-style perforator flap in different forms such as V-Y advancing flap,rotating flap,and propeller flap,which had with free-style perforator in pedicle all.We transplanted the flaps to repair nasal defects after tumor resection.The area of the flaps was between 2 cm x 1.0 cm and 8.0 cm x 5.0 cm,and the diameter of the perforate vessel in the pedicle of flap was between 0.3 mm-3 mm,and some of the pedicles were composed of perforate vessel tube bundle.In order to reduce recurrence rate,the radiotherapy was performed according to the pathology in 1 month after surgery.Results In 31 cases of this group,29 cases were performed and the postoperative shape was good.1 case appeared postoperative hemorrhage,and the epidermis of flap formed blister because of greater tension,and the patient healed 10 days later after extraction the bubble fluid and changing medicine.The flap of 1 case was silted because the venous was blocked,and the acupuncture was treated,and then the flap got delayed union.23 cases received adjuvant radio therapy after surgery and fellowed up from 6 months to 5 years,showing that local profile and color were satisfacfory without tumor recurrence.Conclusions It is worthy of clinical promotion to designing freetype perforator flap and to repair defect after extensive nasal tumor resection on the basis of beauty subunits in nasal and vascular anatomy,which can not only reduce the recurrence rate by postoperative radiotherapy in time,but also realize better cosmetic requirements.

Objective To explore the clinical significance of protection "Choke vessel area" in the application of perforator flap to repair large defect of trunk after tumor resection.Methods A total of 62 patients (38 males and 24 females,aged from 19 to 79 years) from the Department of Plastic Surgery,Second Affiliated Hospital of Suzhou University underwent reconstructive surgery for large area defects of the trunk from March 2012 to January 2016.The perforator flap was designed according to the perforator location detected by Doppler before surgery.The flaps were harvested on the pedicle of perforators and dissected on the deep layer of deep fascia (including part of the myolemma).The areas of flap ranged from 5.0 cm × 10.0 cm to 19.0 cm × 22.0 cm.The donor site was sutured directly or local flap was transferred to repair.Results Flaps survived well in 59 of the 62 cases.The tip of flap was necrotic and healed after dressing change in 1 diabetic patient.The distal part of flap was necrotic on cuticular layer and healed after dressing change in another patient with scrotal defect.One patient had flap necrosis 10 days after operation and was repaired twice.The results were satisfied after following-up from 3 months to 2 years for 17 cases and from 6 months to 2 years for 25 cases.Fibrosarcoma protuberant and squamous cell carcinoma recurred in 1 case each,but the function and appearance were satisfactory after primary repair.Conclusions The procedure of preserving Choke vessel area can improve the blood supply of perforator flap and obtain larger survival area and survival quality.It is worthy of clinical application.

Objective:To evaluate the quality of life (QoL) of Chinese chronic pancreatitis (CP) patients based on the Chinese version of the pancreatitis quality of life Instrument (PANQOLI) and explore its impact factors.Methods:404 patients with CP admitted to the Department of Gastroenterology of the First Affiliated Hospital of Naval Medical University between September 2021 and January 2022 were enrolled. The Chinese version of PANQOLI was used for questionnaire survey on QoL of CP patients. Univariate analysis and multiple linear regression analysis were used to explore the impact factors for QoL of CP patients.Results:The total score of QoL of 404 Chinese CP patients was 28-94(72.47±13.61), which declined by 29.64% compared to the highest total score (103) in the Chinese version of PANQOLI. Score of physical function, role function, emotional function, and self-worth domain was 25.63±4.84, 13.86±2.78, 16.98±6.21 and 16.00±4.65, respectively. Compared to the highest scores (30, 25, 24 and 24), the scores of aforementioned four domains declined by 14.57%, 44.56%, 29.25% and 33.33%, respectively. Univariate analysis showed that sex, age, employment status, smoking, alcohol consumption, and frequency of pancreatitis recurrence were significantly associated with QoL of CP patients. Multiple linear regression analysis indicated that older age (coefficient=-0.127), unemployment status (coefficient=-0.106), smoking (coefficient=-0.176), and high frequency of pancreatitis recurrence (coefficient=-0.123) were independent factors for QoL of CP patients (all P value <0.05). Conclusions:The Chinese version of PANQOLI could be effectively applied to Chinese CP patients. Older age, unemployment, smoking, and pancreatitis attacks were risk factors for QoL of CP patients, indicating that the formulation of personalized intervention measures may help to improve QoL of CP patients.