Objective To evaluate the methods of correction for secondary deformity after removal of polyacrylamide hydrogel in breast.Methods From June 2006 to December 2007,the Center of Breast Plastic and Reconstruction at Chinese Academy of Medical Sciences admitted and treated 36 patients who experienced deformity after polyacrylamide hydrogel remoral in breasts.The average age of the patients was 27.5 years,and the time of consultation for the correction was from 6 months postoperatively.The patients who had preoperative MRI examinations showed that no visible polyacrylamide hydrogel remained in the breast were included in the study.The patients were classified according to the deformity of the breast and the chest wall tissue.Autologous fat injection grafting,silicon gel implant augmentation,and dermis grafting were performed for treating the deformity of the breasts after polyacrylamide hydrogel removal.Results During 3 to 18 months follow-up,the shape of the breast was improved and no complications such as infection,the sclerotic nodules,implant exposure occurred.35(97.2%) patients were satisfied with the result of the operations.Conclusions The correction for secondary deformity of breast after removal of PAHG should be performed at least 6 months after removal of polyacrylamide hydrogel.The optimal and nature contour of the breast may be recovered by combination of various surgical methods which are carefully selected according to the individual situation.

Objective:To explore a good method which might be used to reconstruct the nasal deformity after unilateral complete cleft lip has been repaired. Methods: After being folded into a small column, the conchal cartilage was transplanted into nasal columella to reconstruct the frame of the nasal columella so that the nasal tip was supported strongly. Then the bilateral columella cartilages were raised to its normal and symmetrical position and then sutured to the conchal cartilage column. After that, a "Z" plasty was made on the ridge of nasal mucosa under nostril on the side of the cleft. Results: A total of 44 cases were treated by the method above, and above 90% of cases were evaluated as satisfactory. Conclusion:It is a good method to reconstruct the nasal deformity by transplanting conchal cartilage into nasal columella.

By analysis on existing problems of the classification, the suggestions were put forward to provide a reference for improving the classification of medical devices.
Equipment and Supplies ; classification

Objective To analyze the serum level of 25-hydroxy vitamin D [25-(OH) D] in pregnant women in Nanjing and its relationship with age,gestational week,pre-pregnancy body mass index (BMI) and season,so as to provide some guidance on clinical application of vitamin D measurement and supplementation.Methods 880 pregnant women (in 21-36 gestational weeks) regularly visiting antenatal clinic in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University were selected from January to December 2015.Their serum 25-(OH)D concentrations were measured by enzyme-linked immunosorbent assay (ELISA).Results The mean serum 25-(OH) D concentration in these pregnant women was (42.03 ± 19.22) nmol/L and sufficient in only 42 (4.77％).Vitamin D levels showed seasonal variation (P =0.0164),with the levels in summer [(44.61 ±23.57) nmol/L] and autumn [(43.43 ± 19.31) nmol/L] being higher than spring [(39.68 ± 16.91) nmol/L] and winter [(39.65 ± 13.36) nmol/L].There was no statistically significant difference in serum vitamin D level among different gestational weeks (P =0.929 4).There was statistically significant difference in serum vitamin D level among different age groups (P =0.038 3).Vitamin D level was not associated with pre-pregnancy BMI.Conclusions Vitamin D deficiency is highly prevalent among pregnant women in Nanjing.We suggest vitamin D testing be carried out more actively.

Schistosomiasis is a kind of zoonosis with serious hazard,which is popular in many countries and regions in the world. One of the efforts for schistosomiasis prevent and control is developing new drugs and vaccines,and knowing the tran?scription regulation mechanism and the function of transcription factors will help us find the targets of new drugs and vaccines as soon as possible. This article reviews the progress of Schistosoma transcription factors and research methods.

Streptomyces sp.X-435 isolated from a soil sample collected in the suburbs of Beijing was proved to be a produce Virginiamycin.To improve the productivity of the Virginiamycin of Streptomyces sp.X-435,the spores of strain X-435 were treated with UV.The three types of colony,strawhat,wrinkled,blad,were isolated on Gaose's medium plates after mutation.Among them,the colonies of strawhat type exhibited positive mutation and were picked up as objects of screening.After five generation of mutation,the mutant F5-25-u-28 was selected which potency of Virginiamycin was about 20times higher than that of the beginning strain by flask fermentation and was also genetic stable.

Objective To explore the metabolic characteristic of prostate cancer (PCa) in central gland with magnetic resonance (MR) spectroscopic, and evaluate the value of MRS in the differential diagnosis of benign prostatic hyperplasia nodus. Methods MR images were performed in 38 cases with prostate disease by 3.0T MR, 11 cases with PCa in central gland and 27 cases with benign prostatic hyperplasia nodus. All the cases were scanned by routine, then by the combined MRS. MRS findings were reviewed in 27 cases with benign prostatic hyperplasia (BPH) and 11 cases with PCa (3 in central gland origin, 8 with large tumor invading both peripheral zone and central gland). (Cho+Cr)/Cit ratios of PCa and BPH were retrospectively measured, (Cho+Cr)/Cit of PCa voxels were compared with that of BPH voxels. Results Significantly higher choline levels and lower citrate levels were observed in central gland of PCa compared with BPH. In the glandular BPH region, the amount of Cit was high; while in the stromal region, the Cit and Cho level was much lower. The average (Cho+Cre)/Cit values of PCa and BHP were 1.94±1.43 and 0. 83±0. 28 respectively, the difference in ratio between both was statistically significant (P＜0. 01). Conclusions The combined use of MRI and MR spectroscopy is propitious for differentiating prostate cancer in central gland and benign prostatic hyperplasia nodus and for increasing the diagnostic accuracy of prostate cancer.

Objective To investigate the time-dependent changes in glutamate (Glu) and 7-aminobutyric acid ( GABA) release in the rostral ventromedial medulla in a rat model of incisional pain. Methods Healthy male SD rats weighing 250-300 g were used in this study. Twelve rats in which microdialysis cannulae were implanted in the right rostral ventromedial medulla without neurological deficits were randomly divided into 2 groups ( n = 6 each): group A control and group B incisional pain. In group B an 1 cm long incision was made in the plantar surface of right hindpaw under 1.2% isoflurane anesthesia which was maintained for 5 min. Samples of dialysate were collected before incision (T_0 baseline) and at 3 h, 1 d, 2 d and 3 d after incision was made (T_(1-4)) in both groups for determination of Clu and GABA concentrations (by HPLC). Results In group B Glu and GABA concentrations in the dialysate were significantly increased at 1 d (T_2) and 3 h-3 d (T_(1-4)) respectively as compared with the baseline value at T_0 and were significantly higher than those in group A (control group). Conclusion Incisional pain increases the release of Glu and GABA in the rostral ventromedial medulla which might influence the function of descending pain modulation pathway.

Objective To explore whether dynamic contrast-enhanced MRA (DCE MRA) can provide an effective assessment of renal vascular in living donors before transplantation.Methods Thirty five healthy living renal donor candidates were scanned on MR system before transplantation.After injection of Gd-DTPA 1 ml in vein, a test-bolus scan was used to get the time delay of Gd-DTPA reaching renal artery.Then, a 3D T1-weighted fast low-angle shot sequence (3D FLASH) was performed in the coronal plane.The 3D FLASH scan would repeat four times with an inter-phase of 10 seconds.Thus, the imaging of the renal arterial, venous and collecting systems were got.Two radiologists observed renal arteries and veins on original imaging and MIP reconstructed imaging.The quality of MR angiography was evaluated on a fivepoint scale and the vascular anatomy or variations of the arterial and venous systems were recorded, using intraoperative findings as a standard of reference.Results The quality for all MRA was good or very good for the most of living renal donors.Among 70 renals, several variations of vascular were found, including 5 left accessory artery, 9 right accessory artery, 3 left proximal arterial branch and 6 right proximal arterial branch.Among 70 renal veins, 1 right accessory veins and 2 left varieocele were observed.One small accessory artery of right kidney was missed with DCE MRA, but identified by operation.Conclusion DCE MRA was noninvasive tool for evaluation of the renal vasculature and variations with high accuracy.It would be a good modality in preoperative evaluation of living renal donors.

Objective To evaluate the efficacy of dual stent placements for the treatment of occlusion/stenosis of subclavian artery associated with stenosis of adjacent vertebral artery initial site. Methods The clinical data of 9 patients with occlusion/stenosis of subclavian artery associated with stenosis of adjacent vertebral artery initial site were retrospectively analyzed. Stent implantations in the affected subclavian artery and vertebral artery were separately performed; the patients were followed up for 3-12 months after the treatment. The therapeutic efficacy was evaluated with the clinical symptoms and Doppler ultrasonic examination. Results Successful implantation of two stents was accomplished in all 9 patients, with the technical success rate of 100%. After the treatment, the blood flow in both the subclavian and vertebral arteries was unobstructed. Following-up examination showed that the subjective symptoms were obviously improved in all 9 patients, and no serious procedure-related complications occurred. Doppler ultrasound examination showed that no in-stent restenosis or stent displacement was observed. Conclusion For the treatment of occlusion/stenosis of subclavian artery associated with stenosis of adjacent vertebral artery initial site, dual stent placement technique is a safe and feasible means with satisfactory effect in improving vertebro-basilar arterial insufficiency.