Forehead ; surgery ; Humans ; Nose ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

OBJECTIVETo explore the application of the horn shaped fasciocutaneous flap for the middle or small defect of low leg.

METHODSBetween April 2008 and November 2010,12 cases were covered the defects with horn flap in the leg, in which 4 cases were male, and 8 cases were female, such as squamous cell carcinoma, basal cell carcinoma, angioneoplasm, trauma and so on. Surgical repair of tissue defect size of about 3 cm x 3 cm-5 cm x 5 cm.

RESULTSTwelve cases were treated. Vascular deficiency happened at the distal end of one flap. All the other 11 flaps survived. The appearance and functional results were satisfactory with following up for 6 to 24 months.

CONCLUSIONSThe horn shaped fasciocutaneous flap is simple, reliable, easy to perform, has a low complication rate, is cosmetically acceptable

Adult ; Fascia ; transplantation ; Female ; Humans ; Leg ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Young Adult

Adolescent ; Adult ; Athletic Performance ; psychology ; Back ; physiology ; Electromyography ; Exercise ; physiology ; Humans ; Imagery (Psychotherapy) ; Male ; Young Adult

Objective To explore the characteristics of human plague using a sero-epidemiologic method in the source of the three rivers area in Qinghai for possible plague control strategies. Methods Investigate human plague sero-epidemiologically in the source of 4 counties in the three rivers area in Qinghai. The human serum would be tested to confirm the sew-positive rate for plague F1 antibody using indirect hemagglutination assay(IHA). Results A total of 2508 local participants were tested in 4 counties, the overall plague sero-positive rate was 2.31%(58/2508). This represents a statistically significant difference with 4 counties(X2=19.30,P<0.01). The sew-positive rate for males and females were 2.54% (32/1261) and 2.09% (26/1247), respectively. There were no statistically significant differences between males and females(X2= 0.65,P 0.05). The sero-positive rate in herdsman, cadre, Tibetan, Hart nationalities were 3.54% (44/1243), 6.47% (11 / 170), 2.40% (56/2335) and 1.47% (2/136), respectively. The sero- positive rate increased with age. The highest titre for human plague serum antibody was 1 : 640. Conclusion There were occult infections of plague in the population on source of three rivers area in Qinghai. Sero-epidemiologic data revealed that the human plague sero-positive rate was closely correlated with the local animal plague.

OBJECTIVETo evaluate the effect of early application of high-volume hemofiltration treatment (HVHF) on the levels of lactic acid, pro-inflammatory cytokines and C-reactive protein (CRP) in plasma, as well as APACHE II score in patients suffering from severe sepsis.

METHODSThirty patients meeting the diagnosis of severe sepsis were enrolled in the trial within 24 hours of insults. The level of lactic acid, interleukin-6 (IL-6) and CRP in plasma were measured before HVHF and at 24, 48 or 72 h following HVHF treatment.

RESULTThe plasma levels of lactic acid and IL-6 decreased significantly at 24 h, 48 h, 72 h after HVHF (P <0.05), while, IL-10 did not differ significantly following HVHF (P>0.05), when compared with that before HVHF.

CONCLUSIONThe early application of HVHF could clear the plasma lactic acid and pro-inflammatory cytokines, and improve the tissue oxygenation in severe sepsis.

APACHE ; Adult ; C-Reactive Protein ; analysis ; Female ; Hemofiltration ; methods ; Humans ; Interleukin-10 ; blood ; Interleukin-6 ; blood ; Lactic Acid ; blood ; Male ; Middle Aged ; Sepsis ; blood ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo analyze the clinical characteristics, influencing factors and outcome of recurrent patients with early stage bulky cervical carcinoma.

METHODSBetween January 1(st) 2000 and December 31(st) 2009, 76 patients with stage Ib2 and IIa2 bulky cervical carcinoma developed recurrence and (or) metastasis. The recurrence time, recurrence location, recurrence-related factors, treatment and survival were analyzed.

RESULTSThe median follow up was 44 months (9-137 months). The overall recurrence and (or) metastasis rate was 22.6%. The 1-, 1-2, 3-5 and 5-year recurrence and (or) metastasis rates were 38.2%, 27.6%, 30.3% and 3.9%, respectively. The 5-year survival rate of local recurrence was 34.5%, that of distant metastasis was 23.6%, and that of distant metastasis with synchronous pelvic recurrence was 11.1%, (P = 0.555). The 5-year survival rate of patients who received surgery plus chemotherapy, radiation plus chemotherapy and chemotherapy alone after recurrence and (or) metastasis were 53.3%, 30.7% and 24.6%, respectively (P = 0.686). Univariate analysis demonstrated that tumor recurrence and (or) metastasis in patients of the stage Ib2 and IIa2 bulky cervical carcinoma were influenced by the disease stage, pelvic lymph node metastasis, deep cervical stromal invasion, lymphovascular tumor thrombus and pathological types. Multivariate regression analysis demonstrated that pelvic lymph node metastasis, lymphovascular tumor thrombus and pathological types were the key factors affecting the recurrence and (or) metastases of the stage Ib2 and IIa2 bulky cervical carcinoma. Subgroup analysis showed that pelvic lymph node metastasis and stage were the main factors affecting the local recurrence in those patients, and the pathological type, vascular tumor thrombus and pelvic lymph node metastasis were the main factors affecting the distant metastasis.

CONCLUSIONSRecurrence and(or) metastasis of early stage bulky cervical cancer are mostly happened within 2 years post operation. Patients with pelvic lymph node metastasis have high probability to develop local recurrence and distant metastasis. Patients with non-squamous cell carcinoma and lymphovascular tumor thrombus are more likely to develop distant metastasis. Neoadjuvant chemotherapy does not decrease local recurrence and distant metastasis in patients with stage Ib2 and IIa2 bulky cervical carcinoma. Individualized treatment is advised for recurrent patients.

Adenocarcinoma ; pathology ; secondary ; surgery ; therapy ; Carcinoma, Squamous Cell ; pathology ; secondary ; surgery ; therapy ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lung Neoplasms ; drug therapy ; secondary ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Multivariate Analysis ; Neoadjuvant Therapy ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; surgery ; therapy ; Neoplasm Staging ; Pelvis ; Radiotherapy, Adjuvant ; Survival Rate ; Tumor Burden ; Uterine Cervical Neoplasms ; pathology ; surgery ; therapy

OBJECTIVETo investigate whether S. aureus could activate NF-κB signaling pathway in human osteoblasts.

METHODSImmunoblot and electrophoretic mobility shift assay were used to detect the degradation of I-κBα and activation of NF-κB in human osteoblasts following infection with S.aureus, respectively, and there were investigated the activated state of NF-κB signaling pathway in human osteoblasts. In addition, enzyme-linked immunosorbent assay was used to measure the secretion of IL-6 in culture supernatants, which was represented as one of important cytokines in osteomyelitis, and an inhibitor of NF-κB, SN50, which was added to human osteoblasts culture prior to 1 hour at 50 µmol/L before the infection of S.aureus, was used to determine whether S.aureus-activated NF-κB signaling pathway regulates IL-6 secretion of human osteoblasts.

RESULTSS.aureus could induce the degradation of I-κBα (I-κBα(15 min)/I-κBα(0 min) = 0.409 ± 0.245 and I-κBα(30 min)/I-κBα(0 min) = 0.061 ± 0.010) and activation of NF-κB in human osteoblasts in a time and dose-dependent manner following infection. In addition, the secretion of IL-6 in the supernatants of human osteoblasts ((2.17 ± 0.11) µg/L) was suppressed by 50 µmol/L SN50 compared to without the addition of SN50 ((3.58 ± 0.31) µg/L) (F = 174.25, P < 0.05).

CONCLUSIONSS.aureus could activate NF-κB signaling pathway in human osteoblasts, which could regulate cytokines secretions of human osteoblasts.

Cells, Cultured ; Humans ; Interleukin-6 ; secretion ; NF-kappa B ; metabolism ; Osteoblasts ; metabolism ; Signal Transduction ; Staphylococcal Infections ; metabolism

OBJECTIVETo explore the feasibility and safety of enteral nutrition in preoperative bowel preparation for rectal cancer patients undergoing radical operation.

METHODSSixty rectal cancer patients undergoing selective low anterior resection were randomized into the trial group(n=30) and the control group(n=30). Patients in the trial group received clean liquid integral protein diet for 3 days before operation without mechanical bowel preparation. Patients in the control group received traditional diet and mechanical bowel preparation. The intraoperative and postoperative clinical data, the quality of bowel preparation, postoperative complications, and nutritional parameters were compared between the two groups.

RESULTSThere were no significant differences in clinicopathological characteristics between the two groups before operation. The operative time, blood loss, quality of bowel preparation as well as postoperative hospital stay were not significantly different(all P>0.05). While the time to first flatus [(2.53±0.91) d vs. (3.03±0.68) d] and semi-liquid diet intake[(3.95±0.83) d vs. (4.52±1.14) d] were significantly shorter in the trial group as compared with the control group(all P<0.05). There were no death and no significant difference in postoperative complications [16.7%(5/30) vs. 20.0%(6/30), P>0.05]. The levels of postoperative total protein, albumin, and prealbumin decreased significantly. Meanwhile, the levels of postoperative albumin[(36.2±2.5) g/L vs. (33.5±2.6) g/L, P<0.01] and prealbumin [(325.4±28.2) mg/L vs. (302.5±34.2) mg/L, P<0.01] in the trial group were significantly higher than those in the control group.

CONCLUSIONSPreoperative enteral nutrition can replace the mechanical bowel preparation with better efficacy, and improve the postoperative nutritional status without increasing surgical risk in rectal cancer patients undergoing radical operation.

Digestive System Surgical Procedures ; adverse effects ; Enteral Nutrition ; Humans ; Postoperative Complications ; Preoperative Care ; methods ; Rectal Neoplasms ; surgery

OBJECTIVETo investigate the feasibility of using modified peroneal tendofascial compound flap with partial tendon of peroneal long muscle in lower leg refractory defect with Achilles tendon rupture.

METHODSBased on the application experience of peroneal tendofascial compound flap for lower leg refractory defects, partial tendon of peroneal long muscle was included in the flap to repair the Achilles tendon rupture.

RESULTS6 cases were treated. The maximum size of modified compound flap reached 5 cm x 5 cm. The maximal included tendon in the flap was 5 cm in length. All the flaps survived completely. Partial epidermis necrosis happened in one case between the skin graft at the donor site and the edge of the flap pedicle. The patients were followed up for 5 months to 2 years with satisfactory cosmetic and functional results.

CONCLUSIONSThe modified compound flap has reliable blood supply and can be easily transposed, leaving less morbidity at the donor site. It is very suitable for lower leg refractory defect with the Achilles tendon rupture.

Achilles Tendon ; injuries ; Adult ; Aged ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Surgical Flaps ; Tendon Injuries ; surgery ; Treatment Outcome

OBJECTIVETo observe the effect of hypertonic sodium chloride hydroxyethyl starch 40 injection (HSH) in treatment of acute intracranial hypertension complicated by hemorrhagic shock in dogs, and explore the mechanism of the effects of HSH.

METHODSTwenty dogs were randomized into 4 equal groups, namely the 7.5% NaCl (HS) group, Ringer-Lactates solution (RL) group, hydroxyethyl strarch (HES) group, and HSH group. Canine models of acute intracranial hypertension complicated by hemorrhagic shock were established by epidural balloon inflation with saline and rapid discharge of the arterial blood. One hour after the induced shock, the dogs were given HS (6 ml/kg), RL of 3-fold volume of blood loss, HES of equivalent volume of blood loss, and HSH 8 ml/kg in the 4 groups, respectively. During the shock and resuscitationperiod, the intracranial pressure (ICP), mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) of the dogs were monitored, and the serum sodium level and plasma osmolality were measured at 30 min, 1 h and 4 h after the resuscitation.

RESULTSAll dogs had similar MAP, CPP, and ICP before resuscitation (P>0.05). After resuscitation, the MAP was significantly improved (P<0.01), but the dogs in HSH group exhibited the fastest response; with the exception of the dogs in HS group to have significantly decreased MAP 2 h after resuscitation (P<0.01), all the other dogs maintained the MAP for 4 h. The CPP was also significantly increased after resuscitation (P<0.01), and in HS group, CPP decreased significantly after 2 h (P<0.01), and HSH group maintained the high CPP after 4 h. The ICP was increased significantly in RL and HES groups after resuscitation (P<0.01), reaching the peak level at 1 and 3 h, respectively, but in HS and HSH groups, the ICP decreased significantly to the lowest level at 1 h (P<0.01) which was maintained for 4 h. After resuscitation, the plasma sodium and plasma osmolality were significantly increased in HSH and HS groups.

CONCLUSIONIn dogs with acute intracranial hypertension and hemorrhagic shock, HSH can effectively resuscitate hemorrhagic shock and decrease ICP, and the effect is longer-lasting than that of HS.

Acute Disease ; Animals ; Dogs ; Female ; Hydroxyethyl Starch Derivatives ; administration & dosage ; therapeutic use ; Intracranial Hypertension ; drug therapy ; etiology ; Male ; Plasma Substitutes ; administration & dosage ; therapeutic use ; Random Allocation ; Saline Solution, Hypertonic ; administration & dosage ; therapeutic use ; Shock, Hemorrhagic ; complications ; drug therapy ; Treatment Outcome