OBJECTIVETo investigate the effect of the modified expanded forehead skin flap in nasal reconstruction.

METHODSAccording to flap design, the frontal arteries that were not selected as the pedicle were ligated in order to enhance expansion and delay effects. Besides the middle forehead skin flap for nasal reconstruction, the expanded transversal forehead flap was employed with its donor site sutured directly, resulting in inconspicuous scar. This method was used for 11 cases of nasal reconstruction.

RESULTSAll the flaps survived. Postoperative follow up for 6 months to 8 years and 4 months showed satisfactory results with good appearance and function.

CONCLUSIONSThe method of modulating the blood supply to the flap and selecting the upper area of the forehead for the flap is an effective modification for nasal reconstruction.

Adolescent ; Adult ; Female ; Forehead ; surgery ; Humans ; Male ; Rhinoplasty ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; Young Adult

OBJECTIVETo observe the healing and bone formation of the autogenous particulate bone graft and osseointegration of the implants in shaped titanium mesh with autogenous particulate bone graft and simultaneous implant for reconstructing segmental mandibular defect in dogs.

METHODSFive Beagle dogs were prepared with unilateral 40 mm segmental mandibular defect. Titanium mesh was shaped according to the mandibular defect and was fixed with titanium screws. The ablated mandibular bone and iliac bone were crashed to approximately 2 mm particulates which then filled the titanium mesh tightly (cortical bone:cancellous bone, 3:1). Two implants were placed in the autogenous particulate bone graft. The dogs were sacrificed after six months. X-ray films, histological sections, Scanning electron microscopy(SEM) and Energy disperse analysis of the reconstructed mandibles were examined to evaluate the bone formation of the bone graft and osseointegration of the implants.

RESULTSThe outline of the reconstructed mandible was satisfactory and its function was excellent. The ossific fusion among the particulate bone grafts was fine and no resorption was found. All implants showed excellent osseointegration with the bone graft. The bone near the implant was more compact than the bone away from it. The structure of the bone near implant was optimized because of simultaneous implant in shaped titanium mesh.

CONCLUSIONSThe shaped titanium mesh with autogenous particulate bone graft is a good method for reconstructing segmental mandibular defect, and simultaneous implant is feasible in the reconstructed mandible in dogs.

Animals ; Bone Transplantation ; methods ; Dental Implantation, Endosseous ; methods ; Dogs ; Female ; Male ; Mandible ; surgery ; Surgical Mesh ; Titanium ; Transplantation, Autologous

OBJECTIVETo assess the correlation between familial clustering of hepatocellular carcinoma (HCC) and the level of anti-P53 in human serum in Guangxi.

METHODSEnzyme-linked immunosorbent assay (ELISA) was used to detect anti-P53 in 164 members from 20 HCC families and 164 members from non-cancer control families. Univariate analysis was performed to assess the correlation between seral level of P53 antibody and familial clustering of HCC.

RESULTSThe level of P53 antibody was significantly higher in the members of HCC families than controls (Z=-3.04, P=0.002). After eliminating the interference of hepatitis B virus infection, this tendency still remains (P=0.011). And there was a significant difference between relatives of different degrees from HCC families (chi-square=11.593, P=0.021), with the expression of anti-P53 declining along with decrease in relationship coefficient. Furthermore, the number of individuals with high anti-P53 expression was also significantly greater in HCC families (95/164) than controls (71/164) (P=0.006). And the expression was rising along with the increasing HCC numbers (chi-square=16.068, P=0.000). Anti-P53 level was also greater in HCC families featuring sibling affection than parental affection (chi-square=12.679, P=0.002). Univariate analysis indicated that high expression of anti-P53 is a risk factor for development of HCC (OR=2.087, 95%CI: 1.270-3.431).

CONCLUSIONHigh level of anti-P53 expression may be a factor for the clustering of HCC families in Guangxi, China.

Adolescent ; Adult ; Antibodies, Neoplasm ; blood ; genetics ; Carcinoma, Hepatocellular ; blood ; genetics ; immunology ; Child ; China ; Cluster Analysis ; Family Health ; Female ; Humans ; Liver Neoplasms ; blood ; genetics ; immunology ; Male ; Risk Factors ; Tumor Suppressor Protein p53 ; immunology ; Young Adult

OBJECTIVETo understand the current epidemic situation and high risk factors of human immunodeficiency virus (HIV) infection among paid blood donors living in Shandong provincial China Comprehensive Response (CARES) Project Areas.

METHODSAll residents between 20 to 60 years old were selected from one or several counties in August 2003.

RESULTSThere were 19 HIV(+) infections among 661 subjects interviewed. HIV prevalence rate among paid blood donors was higher (3.98%) than that of others (0.48%) while HIV prevalence rate was higher in plasma donors (7.24%) than that in both plasma and full blood donors (2.90%). There was no infections identified in full blood donors. Donors who donated blood during 1994 - 1995 had a higher prevalence rate (7.07%) than those who started donation after 1995 and those began donation before 1993 (0.99%). The rate of condom use was lower among paid blood donors (13.72%) than that of others. There was a lower rate of voluntary HIV testing among paid blood donors than that of others.

CONCLUSIONThe main high risk population of HIV infection were paid donors in CARES Project Areas, whose risk factor was plasma donation and were infected mainly before 1995. Both the rate of condom use and HIV testing were all very low, indicating that they knew little on HIV/AIDS and paid less attention to self-proctection. It is necessary to enhance HIV/AIDS health education and behavior intervention on paid blood donors.

Adult ; Blood Donors ; China ; epidemiology ; Female ; HIV Infections ; epidemiology ; HIV Seroprevalence ; HIV-1 ; Humans ; Incidence ; Male ; Middle Aged ; Plasma Exchange ; adverse effects ; Risk Factors ; Seroepidemiologic Studies

OBJECTIVETo investigate the value of QT hysteresis index during treadmill exercise test (TET) in diagnosing coronary heart disease (CHD).

METHODSOne hundred consecutive patients suspected for CHD were referred for TET and selective coronary angiography (CAG). Patients were divided into positive [n = 55, age (56.0 ± 7.9) years] and negative [n = 45, age (53.2 ± 6.7) years] group based on their CAG results. For each TET recording, 50 points were selected for the RR, QTp, and QTe interval measurements. QTp and QTe interval was plotted against corresponding RR interval. QT/RR curve was constructed by connect all point, QT hysteresis index was calculated for each patient.

RESULTSThe QTp [(22.4 ± 10.3) ms vs. (6.7 ± 4.6) ms, P < 0.001] and QTe [(27.1 ± 11.1) ms vs. (7.6 ± 4.6) ms, P < 0.001] hysteresis index of patients in positive group were significantly higher than those in negative group. The sensitivity of QTp and QTe hysteresis index for diagnosing CHD was 89.1% (49/55) and 94.5% (52/55), respectively, and the specificity was 82.2% (37/45) and 80.0% (36/45), respectively. If the patient fulfilled both the classical TET and QT hysteresis criteria, the sensitivity for diagnosing CHD increased to 94.3% (33/35, QTp) and 94.6% (35/37, QTe), and the specificity were both 100% (26/26, 26/26). Moreover, QTp (r = -0.399, P < 0.001) and QTe (r = -0.547, P < 0.001) hysteresis index highly correlated to Duke treadmill score.

CONCLUSIONQT hysteresis index is useful parameter for CHD diagnosis and which could improve the diagnostic value of TET for CHD in combination with the classical TET criteria for diagnosis of CHD.

Adult ; Aged ; Coronary Disease ; diagnosis ; physiopathology ; Electrocardiography ; methods ; Exercise Test ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity

OBJECTIVETo probe blood serum Ab-IgG characteristics of severe acute respiratory syndrome (SARS) patients in Guangzhou and investigate the related factors.

METHODSThe serum of such population diagnosed as SARS convalescent patients, non-SARS patients, family consanguineous contraction persons, wild animal and vegetable salesman and community common people was collected. The lab detective method of ELISA was adopted for these serum samples. And the epidemic investigations for the SARS patients were also carried out.

RESULTSOf these populations, the detective rate of Ab-IgG for the clinic diagnosed SARS patients, which was 53.7%; That for the wild animal salesman and community common people were 16.7% and 0.9%, respectively. Among the clinic diagnosed SARS patients, the positive antibody detective rate was 90.4% for those which had specific contact history or infectivity, which was higher than that for other population. Among the specific contact history or infectivity cases, the antibody positive rate for the young and the old was lower than that for the adult. Meanwhile the difference did not exist among other cases. The antibody positive rate was identical between the male and the female. And the antibody detective rate was decreased by the month.

CONCLUSIONAs a whole SARS-CoV Ab-IgG detective rate for the clinic diagnosed SARS patients was 53.7% only. The reasons for that mainly lie in the wrong clinic diagnosis besides these factors such as age, hormone use and reagent and so on. The combination of lab detection results and epidemic investigation was propitious to the diagnosis veracity. It was impossible for the sub-clinic infection of SARS-CoV virus. The importance in the virus transmitting course need to be further studied.

Adult ; Antibodies, Viral ; blood ; Child ; China ; epidemiology ; Female ; Humans ; Immunoglobulin G ; blood ; Male ; Middle Aged ; SARS Virus ; immunology ; Seroepidemiologic Studies ; Severe Acute Respiratory Syndrome ; epidemiology ; immunology

OBJECTIVETo analyze clinical typing, pathologic characteristics of hilar cholangiocarcinoma (HCCA) and surgical strategies and their effects on HCCA, and to explore the factors that influence the surgical outcomes and long-term survival.

METHODSThe data of the 402 patients with HCCA admitted between January 1993 and December 2004 was investigated retrospectively. Primary outcomes examined included clinical typing, pathologic characteristics, surgical procedures and follow-up results. On the basis of Bismuth-Corlette typing, we defined the tumor originated from intrahepatic large bile duct (LBD) as type V (type Va and Vb).

RESULTSAmong the 402 patients with HCCA, 198 cases accepted curative resection, 102 (51.5%) for radical resection and 96 (48.5%) for palliative resection. Of the rest patients, 8 received orthotopic liver transplantation (OLT), 161 received simple drainage and 35 were not operated on. The resection rates for type I, II, IIIa, IIIb, IV, Va and Vb were 69.4%, 55.5%, 57.4%, 71.7%, 19.6%, 100% and 34.6%, respectively. The one-year survival rates for radical resection, palliative resection, simple drainage and untreated were 80.3%, 53.2%, 26.7% and 9.8%, respectively. And the three-year and five-year survival rates in the four groups were 41.9% and 33.3%, 19.6% and 14.7%, 3.3% and 0, 0 and 0, respectively. Significant difference was found in survival rates between the radical and palliative resection. In the patients who received tumor resection, the ones without lymph nodes metastasis (LNM) survived much longer than those with LNM (P < 0.05). Complications were found in 36.1% of the patients and the mortality rate was 0.3%.

CONCLUSIONSHCCA type V originated from intrahepatic LBD has higher resection rate and better prognosis. The tumor differentiation is significantly correlated with the prognosis after operation. With HCCA, resection is still the major treatment selection. Curative resection carries the best effect. Extended radical resection of liver lobes, blood vessels, lymph nodes can prolong survive. The problem of high recurrence rate after OLT for HCCA has not been solved yet.

Adolescent ; Adult ; Aged ; Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; China ; Cholangiocarcinoma ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis ; Treatment Outcome

OBJECTIVETo identify the status of awareness, treatment and control of hypertension in adult population in Shandong province in China.

METHODSA total of 15 350 representative subjects aged 18 to 69 in Shandong province were selected with multistage stratified and clustered sampling design. Questionnaire investigation and physical examination including measurement of blood pressure, height and weight, were taken for all of them. The prevalence was estimated by weighted SURVEYFREQ model.

RESULTSIn Shandong province, 34.5% of the hypertensive patients were aware of their high blood pressure (31.1% in male, 38.5% in female), 27.5% of them were taking antihypertensive medications (24.1% in male, 31.7% in female), and 14.9% of them (13.7% in male, 16.4% in female) were under control for their blood pressure (<140/90 mm Hg).

CONCLUSIONThe rates of awareness, treatment and control of hypertension in adult hypertensive population in Shandong province, China were low, and it is urgently needed to take steps for intervention and control for hypertension prevention, particularly in rural areas.

Adolescent ; Adult ; Awareness ; Blood Pressure ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; prevention & control ; therapy ; Male ; Middle Aged ; Surveys and Questionnaires