Objective To investigate the correlation between the glycosylated hemoglobin (HbA1c) detection data and hemo‐rheological indicators in diabetes patients to provide reference basis for its treatment and prevention .Methods One hundred and forty‐two patients with typeⅡdiabetes mellitus(T2DM ) in the hospital were selected as the research subjects and divided into the A group(69 cases ,better control) and B group(73 cases ,poor control) according to the HbA1c detection results .Contemporaneous 70 healthy individuals undergoing physical examination were selected as the control (C group) .The detection results of HbA1c ,hemo‐rheology and biochemical indexes were performed the contrastive analysis .Results Except hematocrit and erythrocyte deformation index without statistical difference among 3 groups(P>0 .05) ,the other hemorheologic indicators had statistical differences among 3 groups(P<0 .05) .No matter the HbA1c level in T2DM patients ,the hemorheological indexes ,triglyceride and total cholesterol were higher than those in the healthy people ,When the HbA1c leve was poorly controlled ,the increase degresss of various indexes were more significant .Conclusion The abnormality of hemorheology indices exist in most of the patients with diabetes mellitus .It is recommended that clinic should monitor the HbA1c level for long term and strictly observe the change of hemorheology indexes to guide the clinical treatment for reaching the effects of early vascular protection and prevention of diabetic complications .

Objective:To investigate the expression of chemokine receptor in eupotic and ectopic endometrial tissues of women with endometriosis, and in endometrium of women without endometriosis.Methods:Normal endometrium, eutopic endometrium and endometriotic tissues were obtained from patients with endometriosis at laparoscopy. Total RNA was then extracted using the TRIzol reagent. The expression of chemokine receptors in these tissues were analyzed by way of semi-quantitative reverse transcriptase-polymerase chain reaction.Results:Compared to normal endometrium, the eutopic endometrium expressed significantly more CCR6, CCR8, CCR9 and CX3CR1(P

Objective To report the clinical effect of repair of significant tongue defect after tongue cancer radical resection using anterolateral thigh perforator free flap with CTA three-dimensional reconstruction technique assistance.Methods From January,2012 to November,2015,13 cases were performed using anterolateral thigh perforator free flap in the repair of significant tongue defect after tongue cancer radical resection.Preoperation CT scan of the free flap donor site was done to obtain the three-dimensional images of arterial blood area by Digital Three-dimensional Reconstruction CT Technique to determine the origin of the anterolateral thigh flaps,direction,classification,length,diameter and the position of pedicle perforator.According to the condition of the defect of the tongue,flap of area from10 cm×9 cm to 8 cm×6 cm was design,the flap arteries and veins were anastomosed with the external maxillary artery or the superior thyroid artery,anterior vein,internal jugular vein or external jugular vein respectively.The shape and recovery of function of the reconstructed tongue were observed regularly after operation.Results All the flaps in the 13 cases survived,in the postoperative 4 to 18 months followed up,the appearance of the reconstructed tongue was close to the normal one,the patients were satisfied with the mastication and feeding function.Conclusion CTA three-dimensional reconstruction technique assisted anterolateral thigh perforator free flap technique is useful in obtaining good clinical effect,and it is one of the most best methods for repairing significant tongue defect after tongue cancer radical resection.

Objective To explore the clinical value of applying digital technology to make the course of toe vein clear before toe free flap transplantation for thumb reconstruction.Methods Before operation,scan the donor and recipient site by CT,and apply digital three-dimensional CT angiography reconstruction technology to got threedimensional images of the arteries and veins in the donor site for 22 various defected thumbs which were going to have toe free flap transplantation operation,thus indentifyed the types of FDMA and the distribution and course of the toe vein from June,2012 to March,2013.Used computer assisted anatomical modeling to analyze three-dimensional images of blood supply of the donor site and degree of defect of the recipient site and guide the operative design in the donor site according to the digital three-dimensional reconstruction technology.Conducted toe free flap transplantation for thumb reconstruction in accordance with the design.Results It shows that 64-slice dual-source spiral CT could well display the size,distribution and course of toe vein.The toe veins were clarified to two groups,deep one and superficial one whose diameter was larger and was the main reflux vein of the toe.Dorsal vein of the toe origind from venous plexus in the nail bed and it travels along the back of the toe to reach to the near side of metatarsophalangeal joint.And then it beeomes three to four dorsal metatarsal veins to infused dorsal venous arch of foot.The rule of its course was:centralize-decentralize-connect-decentralize again.The great saphenous vein origins from the inner side of dorsal venous arch of foot,rises along the crus before malleolus medialis and collect three larger tributaries:medial malleolar branches-anterior crural branch-outside crural branch.The small saphenous vein derives from the outside of dorsal venous arch of foot and winds behind lateral malleolus up to the back of the curs and infuses to the vein.Conclusion It is useful for venous return,reducing the incidence of vascular crisis by applying toe flap to reconstruct thumbs and clarifying the course and distribution of toe vein with the aid of digital three-dimensional technology to design operation,thus improving the survival rate of toe flap transplantation.

Objective To review clinical experience of free flap transferring in the reconstruction of head and neck defects. Methods Fifteen free anterolateral thigh flaps, 5 free deep inferior epigastric flaps and 3 free lateral arm flaps were used to reconstruct large area head and neck defects. Results All 23 free flaps were alive with good appearance. 1 case survived by performing embolectomy after suffering arterial crisis and delayed recovery of wound took place in 2 cases. Conclusion Free flap transplantation is an ideal choice for reconstructing large area cranio-facio-cervical defects.

Objective To investigate the therapeutic effect of toe transfer in reconstruction and repairation of thumb and finger defcts. Methods From December of 1996 to September of 2010,thirty-five partial thumb and finger defcts in 33 cases were treated with toe tissue for reconstructing and repairing.The transfer indication,surgery procedure,operative technique and treatment effect were retrospectively analyzed.Simultaneously how to improve the outcoming and success rate were explored and investigated.Results All 35 toe tissue were alive with aesthetic appearance and finefunction.Followed-up from 3 months to 12 years,and judged by the tentative evalution standard of function of upper limb,which was made by Chinese Medical Association for Surgery of the Hand.The results were excellent in 14,good in 16,fair in 3 and poor in 1.The rate of excellence and good was 85.7%. Conclusion Toe tissue transplantation is an ideal treatment for reconstructing and repairing partial thumb and finger defcts.

OBJECTIVETo assess patients' knowledge, attitudes, and concerns regarding anesthetic management.

METHODA survey of 55 items was developed and administered preoperatively to 500 patients including 190 men and 310 women in our hospital. Patients were interviewed on their knowledge of the role of anesthesiologists, their preferences regarding anesthetic management, and also their concern about potential anesthetic complications.

RESULTSPatients' perceptions of anesthesiologists' training and role have reached a certain level. Most significant preoperative concerns regarding the anesthesiologists focused on experience, qualifications, and presence or absence during the anesthesia. Patients' concerns also included the possibility of not being waken up following anesthesia, experiencing postoperative pain, and becoming paralyzed. The variations of concerns depended partially on patients' sex, type of anesthesia, and proposed surgical procedure, partially on their education and living environments.

CONCLUSIONIt is suggested that anesthesiologist address significant patient concerns during the preoperative visit to enhance their effectiveness in patient care. Efforts to educate the public on the anesthesiologists' role in preoperative care would improve patients' confidence.

Adolescent ; Adult ; Anesthesia ; psychology ; Attitude to Health ; Educational Status ; Elective Surgical Procedures ; psychology ; Female ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Surveys and Questionnaires

Objective:To investigate the clinical value of the free fibula flap transplantation in repair of the defect of tibia and soft tissue with the help of augmented reality (AR) technology.Methods:From May, 2017 to May, 2019, 9 patients with tibial and soft tissue defects were treated. Before operation, CTA scan was performed on both shanks to obtain DICOM data of tibial bone defect. Images of the designed fibular flap and its blood supply model were imported into Sina software through computer virtual surgery assistant technology. With the AR technology, information of virtual fibula flap were projected onto the body surface at the donor site, and the operation was carried out under the precise positioning. In this group, the free fibular flap was harvested with an area of 6.0 cm×4.0 cm-12.0 cm×6.0 cm and the length of fibula was 6.0-13.5 cm. The free fibula flap were used to repair the tibial defect with 5.0-12.0 cm in length and soft tissue defect area at 5.0 cm×3.0 cm-10.0 cm×4.5 cm. Patients were followed-up to observe the survival of fibular flap and the functional recovery of the repaired lower limb, and evaluate the clinical effect.Results:All the fibular flaps survived without vascular crisis and without serious complications occurred at both of donor and recipient sites. After 8-12 months of follow-up, the flap was soft in texture and good in blood supply. The appearance of the repair site was not bloated. Callus began to form at the junction of fibula and tibia at 3-5 months and healed well in 8-12 months. No bone resorption, nonunion, loosening or falling off of screws were found. There was no pain in the shank of the recipient area. Patients could stand and walk freely, and the weight-bearing function was close to normal. According to Enneking system, the average score was 27 points; 7 cases were excellent and 2 cases were good.Conclusion:Application of AR technology in the repair of tibial bone defect with fibular flap transplantation has good clinical effect and has certain practical value.

Objective To evaluate the effect of mild hypothermia on the renal ischemia-reperfusion injury (IRI), and the expression profile of RNA-binding motif protein 3(RBM3) and its downstream effector molecules during this process. Methods Eighteen healthy SD male rats were randomly divided into the normal control (NC) group, IRI group and mild hypothermia pretreat (MHP) group, with 6 rats in each group. Serum creatinine level was measured to evaluate the renal function. Hematoxylin-eosin (HE) staining was performed to assess the renal tissue injury. Western blot was used to determine the relative expression levels of RBM3, Yes-associated protein 1(YAP1), nuclear factor E2-related factor 2(Nrf2), B cell-lymphoma-2(Bcl-2) and Bcl-2-associated X protein (Bax) in the kidney tissues. Immunohistochemical staining was employed to further detect the expression levels of RBM3 and YAP1 proteins. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay was adopted to detect the cell apoptosis of kidney tissues. Malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were evaluated to determine the oxidative stress level of kidney tissues. Results Compared with the NC group, the serum creatinine level, the pathological injury score of kidney tissues and the expression levels of RBM3, YAP1 and Nrf2 proteins were significantly up-regulated, the Bcl-2/Bax ratio was considerably lower, the apoptosis rate was remarkably elevated, the MDA content was significantly increased and the SOD activity was dramatically reduced in the IRI and MHP groups (all P < 0.05). Compared with the IRI group, the serum creatinine level and the pathological injury score of kidney tissues were significantly decreased, the expression levels of RBM3, YAP1 and Nrf2 proteins were significantly up-regulated, the Bcl-2/Bax ratio was considerably higher, the apoptosis rate was significantly decreased, the MDA content was significantly decreased and the SOD activity was considerably elevated in the MHP group (all P < 0.05). Conclusions Mild hypothermia may exert protective effect upon renal IRI and it could alleviate cell apoptosis and oxidative stress injury induced by IRI, probably by up-regulating the expression level of RBM3 and its downstream effector molecules of YAP1 and Nrf2.

OBJECTIVE: To raise clinical awareness of carcinoembryonic antigen(CEA) increased as initial manifestation of medullary thyroid cancer(MTC) and explore the diagnosis and treatment. METHOD: Clinical data of 2 cases CEA increased as the initial presentation of MTC were retrospectively analyzed and clinical manifestations of the disease, diagnosis, treatment were also discussed by literature reviewing. RESULT: Two patients received thyroid ipsilateral lobe total resection, MTC was confirmed by intraoperative frozen pathology, re-total resection of the contralateral lobe and bilateral VI lymph node dissection were performed. Lymph nodes had no metastasis confirmed by pathological frozen examination. CEA returned to normal within 2 months after surgery. No tumor recurrence and metastasis were found after follow-up for 3 to 24 months. CONCLUSION CEA increased as the initial presentation MTC was rare and clinical identification of CEA increased disease should be taken into account the MTC as possible. Total thyroidectomy and bilateral VI lymph node dissection was the main surgical treatment for it.
Adult ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Neuroendocrine ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; metabolism ; pathology