OBJECTIVE: To explore the feasible monitoring techniques for the buried free flap. METHOD: Buried free flaps in reconstruction were monitored using combined monitoring techniques in five cases of advanced hypopharyngeal cancer The monitoring effects were analyzed retrospectively. RESULT: The operations were carried out successfully and all the five patients got primary healing of incision without vascular crisis. Four patients need combined monitoring techniques to confirm the microcirculatory results of the buried free flap. CONCLUSION Application of Doppler combined with flap island was feasible on monitoring the blood supply of post-operative buried free flap, it is a good monitoring technique.
Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; surgery ; Free Tissue Flaps ; blood supply ; Head and Neck Neoplasms ; diagnostic imaging ; pathology ; surgery ; Humans ; Hypopharyngeal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Hypopharynx ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Surgical Flaps ; blood supply ; Ultrasonography, Doppler

We describe a 44-year old man who suffered an isolated external auditory canal granulocytic sarcoma in remission of acute myeloid leukemia. The patient confirmed acute promyelocytic leukemia three years ago and the disease was in remission after treatment. Two months ago he presented pain and hearing loss in the left ear and the symptom developed gradually. At otoscopic examination a tumoral lesion was noted in the external auditory canal and computerized tomography scan showed a mass in the left external acoustic meatus without bone erosion.
Adult ; Ear Canal ; diagnostic imaging ; pathology ; Hearing Loss ; Humans ; Leukemia, Promyelocytic, Acute ; Male ; Sarcoma, Myeloid ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

Adult ; Humans ; Male ; Neck Injuries

Objective To investigate ICU nurses' practice of physical restraints and to explore its influencing factors.Methods Questionnaires were used to investigate 150 ICU nurses from 5 third-grade hospitals in Hengyang City.Results The score of ICU nurses' knowledge of physical restraints was at middle-upper level, while the accuracy rate was 78.70%. The attitude toward physical restraints was neutral. Practice of physical restraints was relatively appropriate and the influencing factors were: age, nursing age, the indications of physical restraints, professional title, feeling of physical restraints, duration of working in ICU and education background of physical restraints.Conclusions The education of physical restraints should be improved, so as to set up the positive feeling of physical restraints, take pertinent measures and improve nursing quality.

OBJECTIVETo evaluate therapeutic results of endovenous radiofrequency in combination with TriVex in treatment of venous insufficiency in lower extremities.

METHODSOne hundred and fifty patients with chronic venous insufficiency (150 limbs) were randomly assigned to Group A (75 limbs) and Group B (75 limbs). Patients in Group A were treated with long saphenous veins radiofrequency ablation procedures in combination with TriVex. Patients in Group B were treated with long saphenous veins traditional stripping operation in combination with TriVex. The postoperative pain, average hospital stay and short-term results in hospital were compared between the two groups. Self-assessment of the operation 4 weeks after, changes of CEAP classification, venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ) score were compared between the two groups.

RESULTSThe operation time in Group A was (67 +/- 11) min, compared with (59 +/- 9) min in Group B (P > 0.05). Postoperative pain and average hospital stay in Group A were significantly lower than those in Group B (P < 0.05). The scores of self-assessment of the operation in Group A was higher than that in Group B 4 weeks after operation (P < 0.05). The change of CEAP classification, VCSS and quality of life were significant after operation in both groups. The VCSS of Group A decreased by 4.6 +/- 2.5 compared with 4.3 +/- 2.7 in Group B (P > 0.05).

CONCLUSIONSEndovenous radiofrequency combined with TriVex for treatment of venous insufficiency in lower extremity is available, effective and with less trauma and faster recovery. CEAP classification, VCSS and CIVIQ are useful tools for assessing outcomes after radiofrequency in these patients.

Adult ; Aged ; Aged, 80 and over ; Catheter Ablation ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Saphenous Vein ; surgery ; Treatment Outcome ; Venous Insufficiency ; surgery

The human basic Krüppel-like factor (hBKLF) is a newly cloned human transcription factor from the cDNA library of fetal liver. It belongs to the Krüppel-like transcription factor family. Previous expression study showed that it is a hematopoietic related factor. This study was aimed to investigate the effect of hBKLF on cell proliferation, differentiation and hemoglobin synthesis by using K562 cell line as model. The sense and antisense expression plasmids of hBKLF were constructed, and transfected into K562 cells by lipofectamine. After G418 selection for 4 weeks, the cell line with stable expression of the gene was obtained. Then the hBKLF expression level, proliferation ability, colony formation and hemoglobin production were detected by RT-PCR and Western blot, MTT method, methyl cellulose semisolid culture method and benzidine test respectively. The morphologic change of cell was observed with inverted microscope. The results showed that the sense plasmid could increase hBKLF level and antisense plasmid could decrease hBKLF expression. When hBKLF level was down-regulated, K562 cells could proliferate more quickly and synthesize more hemoglobin. But there were no differences in colony formation ability and no apparent morphologic change. It is concluded that hBKLF can inhibit hematopoietic cell proliferation and hemoglobin synthesis. It is suggested that hBKLF plays an important role in the proliferation and differentiation of hematopoietic cells.
Animals ; COS Cells ; Cell Differentiation ; physiology ; Cell Proliferation ; drug effects ; Cell Transformation, Neoplastic ; drug effects ; Cercopithecus aethiops ; Hemoglobins ; biosynthesis ; Humans ; K562 Cells ; Kruppel-Like Transcription Factors ; biosynthesis ; genetics ; pharmacology ; Transcription Factors ; biosynthesis ; genetics ; Transfection

OBJECTIVETo investigate the methods of culturing and identifying mouse myeloid semimature dendritic cell (smDC) in vitro.

METHODSMyeloid monocytes derived from 6-week-old C57 BL/6 mice were cultured in RPMI-1640 medium containing 10% fetal bovine serum, 2 ng/ml recombinant murine granulocyte macrophage-colony stimulating factor (GM-CSF), and 20 ng/ml recombinant murine interleukin (IL)-4 for 9 days. Then cells were incubated with 40 ng/ml tumor necrosis factor-alpha (TNF-alpha) for 24 hours to obtain smDC. Meanwhile, smDC was differentiated into mature dendritic cell (mDC) or immature dendritic cell (iDC) by treatment with 1 micro/m1 lipopolysaccharide (LPS) or without LPS. The morphological features of smDC were assayed by inverted microscopy and scanning electron microscopy. Surface markers such as CD11c, CD4O, CD8O, CD86, and MHC-II were tested by flow cytometry. IL-1beta, IL-6, IL-12, and IL-10 in the supernatant were tested by ELISA. The activation of allogene lymphocyte (BALB/c mice) stimulated by C57BL/6 myeloid smDC in mixed lymphocyte reaction was examined by Cell Counting Kit-8 in vitro.

RESULTSThe shape of smDC was round or oval-shaped, and the diameter of smDC was about 15 microm. The length of smDC dendrite was between 5 to 10 microm. smDC, iDC, and mDC all expressed high level of CD11 c. The expressions of MHC-II, CD40, CD80, and CD86 on smDC were higher than those of iDC and lower than those of mDC. IL-1beta, IL-6, and IL-12 secretion of smDC was significantly lower than that of mDC (P < 0.01), and IL-12 was significantly lower than that of iDC (P < 0.05), while no significant difference of IL-1beta and IL-6 secretion was found between smDC and iDC (P > 0.05). Furthermore, IL-10 secretion was not significantly different among these three kinds of DCs (P > 0.05). The effect of allogene lymphocytes activation on smDC was significantly lower than that of mDC and positive control (P < 0.01), but had no significant difference when compared with that of iDC and negative control (P > 0.05).

CONCLUSIONSsmDC may be a relatively independent dendritic cell sub-population in terms of function and morphology. It is a feasible way to induce myeloid monocytes to differentiate into smDC using GM-CSF, IL-4, and TNF-alpha in vitro.

Animals ; Cell Culture Techniques ; Cell Differentiation ; Cells, Cultured ; Cytokines ; immunology ; Dendritic Cells ; cytology ; immunology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Monocytes ; cytology ; immunology

Objective To compare clinical efficacy of open radical mastoidectomy (ORM) and complete bi-style radical mastoid surgery (CRMS) and open radical mastoidectomy-mastoid tamponade(ORM-MT) treatment of cholesteatoma otitis media (COM), and explore treatment measures for cholesteatoma recurrence after surgery. Methods The 130 cases of COM patients were randomly divided into ORM group(46 cases), CRMS group (38 cases) and ORM-MT group (46 cases). The values of average air conduction hearing threshold value and Air-bone difference and recurrence rate during fol-low-up were compared. Results The values of average air conduction hearing threshold value and Air-bone difference in CRMS group after three months were significantly lower than ORM group (q=12.055, 7.761, P<0.01), the values of average air conduction hearing threshold value and Air-bone difference in CRMS group after three months were signifi-cantly lower than ORM group (q=8.764, 11.443, P<0.01). But CRMS group and ORM-MT group had no significant dif-ference (q=1.170, 0.575, P>0.05). Recurrence rate of ORM, CRMS and ORM-MT group was 5 ears (10.9%), 9 ears (23.7%) and 4 ears (8.7%), respectively. Recurrence rate of CRMS group was significantly higher than ORM group and ORM-MT group (χ2=6.640, 9.072, P<0.05). Conclusion CRMS and ORM-MT technique is superior in improving hear-ing function, but CRMS has a higher recurrence rate. Face higher neural crest and poor drainage patients should be performed radical mastoid surgery again.

Objective To investigate the role of nasal mucosa fibrosis on radiation induced nasal mucosa injury. Methods Seventy two male rats were randomly divided into two groups, control group and irradiation injured group (radiation dose were 40 Gy);the rats were killed 1 week, 2 weeks, 4 weeks, 8 weeks, 3 months and 6 months after the finish of radiation. The middle turbinates of the animals were removed. The pathological change of the nasal mucosa were observed with scanning electron microscope, transmission electron microscope, hematoxylin and eosin (HE), alcian blue-periodic acid-Sehif (AB-PAS), and Masson Trichrome (MT). The Hyp content in nasal mucosa was measured with chemo-chromatometry. Results After radiation, the pathological characteristics in early stage (within 4 weeks) was acute inflammatory reaction. The repair of nasal mucosa started 4 weeks after radiation, lasted to 6 months. The deposition of collagen in nasal mucosa could be found 1 week after irradiation and increased gradually. Conclusion Irradiation could induce a serials of pathological changes on nasal mucosa. The nasal mucosa fibrosis may be one of the reasons of persistent irradiation induced nasal mucosa injury.

OBJECTIVETo explore the best intervention time of acupuncture and moxibustion for peripheral facial palsy (Bell's palsy) and the clinical advantage program of selective treatment with acupuncture and moxibustion.

METHODSMulti-central large-sample randomized controlled trial was carried out. Nine hundreds cases of Bell's palsy were randomized into 5 treatment groups, named selective filiform needle group (group A), selective acupuncture + moxibustion group (group B), selective acupuncture + electroacupuncture (group C), selective acupuncture + line-up needling on muscle region of meridian group (group D) and non-selective filiform needle group (group E). Four sessions of treatment were required in each group. Separately, during the enrollment, after 4 sessions of treatment, in 1 month and 3 months of follow-up after treatment, House-Brackmann Scale, Facial Disability Index Scale and Degree of Facial Nerve Paralysis (NFNP) were adopted for efficacy assessment. And the efficacy systematic analysis was provided in view of the intervention time and nerve localization of disease separately.

RESULTSThe curative rates of intervention in acute stage and resting stage were 50.1% (223/445) and 52.1% (162/311), which were superior to recovery stage (25.9%, 35/135) separately. There were no statistical significant differences in efficacy in comparison among 5 treatment programs at the same stage (all P > 0.05). The efficacy of intervention of group A and group E in acute stage was superior to that in recovery stage (both P < 0.01). The difference was significant statistically between the efficacy on the localization above chorda tympani nerve and that on the localization below the nerve in group D (P < 0.01). The efficacy on the localization below chorda tympani nerve was superior to the localization above the nerve.

CONCLUSIONThe best intervention time for the treatment of Bell's palsy is in acute stage and resting stage, meaning 1 to 3 weeks after occurrence. All of the 5 treatment programs are advantageous to Bell's palsy. In the condition of the limited medical sources, the simple filiform needle therapy is recommended in acute stage. For the patients with the disorder above chorda tympani nerve, the line-up needling on muscle region of meridian is not recommended.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Disease Progression ; Facial Paralysis ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult