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

Color vision is a major component of vision function. Examination of color vision mostly relies on subjectivity at present. It is important to establish an objective method of color vision examination that would have particular clinical significance and forensic medicine value. With the development of new technology, the examination of visual electrophysiology has become a basic method of clinical diagnosis and investigation. Electroretinogram (ERG) could discriminate different cone cells and color abnormality. Visual evoked potential (VEP) generated characteristic negative wave after stimulation with different colors. Different visual electrophysiology detection methods were reviewed and in particular important new advancement of color vision research of ERG, F-VEP and P-VEP were introduced. The application prospect of color vision research in the clinical forensic medicine was also discussed. It is likely that color vision research study and visual electrophysiology will provide objective evaluation of retina and brain function.
Color Vision/physiology* ; Electrophysiology ; Electroretinography ; Evoked Potentials, Visual ; Forensic Medicine ; Humans

Objectives: To investigate the status of secondary prevention, treatment and risk factors of retired elderly patients (≥80 years old) with coronary heart disease in Guangzhou. Methods: A total of 752 questionnaires were collected from the elderly patients with coronary heart disease who underwent routine cardiovascular checkup in our hospital from March to May in 2016. The questionnaire included basic situation, complications, weight, blood pressure, low density lipoprotein, glucose level and secondary prevention medications based on evidence-based medicine. Results: Antiplatelet drugs, beta blockers, statins, ACEI/ARB use rate was 55.72%, 30.98%, 25.13%, 42.69% for the secondary prevention; 21.94% patients did not take secondary prevention drugs, the combined use rate of the four drugs was 4.92%. In elderly patients with coronary heart disease, the control rate of blood pressure (<150/90 mmHg), fasting blood glucose (<7mmol/L), 2-hour postprandial blood glucose (<10 mmol/L), body mass index (<24 kg/m2) were 81.17% (470/579 cases), 77.61% (253/326 cases), 55.21% (180/326 cases) and 54.73% (266/486 cases), respectively. With LDL-C<1.8 mmol/L as the standard, percent with normal LDL-C value was 14.06% (63/448 cases). Conclusions: In this survey population, use rate of the four types of drugs for secondary prevention and the control rate of known risk factors for coronary artery disease are very low. Efforts are needed to improve rational use of the secondary prevention drugs, minimize the gaps between promote the guidelines and clinical practice, and reduce the recurrence rate of coronary heart disease in elderly patients with coronary artery disease.

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

Objective:To analyze the influencing factors for depression in primary school children aged 9-10 years in Jiangsu Province, and to construct a risk prediction model.Methods:A retrospective study.A total of 1 162 primary school children aged 9-10 years from 3 primary schools in 3 regions of Jiangsu Province were recruited.Their demographic data were collected, and they were surveyed by the Depression Anxiety Stress Scales-21 (DASS-21), the Strengths and Difficulties Questionnaire (SDQ), and the Family Environment Scale (FES). Children were divided into control group (1 059 cases) and depression group (103 cases) based on the depression scores obtained from the DASS-21 scale.Multivariate Logistic regression analysis was used to analyze the influencing factors for depression in primary school students aged 9-10 and construct a risk prediction model. Results:There were significant differences in the economic development region, physical activities, academic performance, student cadres, parents′ education level, frequency of parental quarrels, SDQ and FES dimension scores between control group and depression group (all P<0.05). Among them, economic development areas (Northern Jiangsu and Southern Jiangsu), student cadres, father′s education level (elementary school and below) and intimacy of the FES scale were protective factors for depression in elementary school children; while emotional symptoms, peer problems and the total difficulty score in the SDQ scale, and the conflict in the FES scale were the risk factors for depression in elementary school children.The prediction model was created based on the influencing factors: Logit ( P)=-1.390×economic development area (Northern Jiangsu) -1.508×economic development area (Southern Jiangsu) -1.248×student cadres -2.206×father′s education level (primary school and below) -1.145×father′s education level (junior high school)+ 3.316×emotional symptoms in the SDQ+ 0.979×peer problems in the SDQ+ 2.520×total difficulty score in the SDQ -1.697×cohesion in the FES + 0.760×conflict in the FES -0.678.The area under the curve of receiver operating characteristic was 0.931, with the sensitivity and specificity of 85.42% and 91.83%, respectively. Conclusions:The regional level of economic development, class or school cadres, father′s education level, peer problems, total difficulty score, cohesion and conflict in the family are influencing factors for depression among primary school children aged 9-10 years in Jiangsu Province.The created prediction model can effectively assess the depressive risk factors in this population, which is conductive to achieve the early recognition and intervention of depression in them.

Objective:To explore the speech features of female patients with anhedonic depression and their recognition of pleasure deficient symptoms.Methods:A total of 102 female depression patients who were hospitalized at Nanjing Brain Hospital from September 2020 to October 2021 were selected, including 62 anhedonic depression patients (anhedonic group) and 40 non-anhedonic depression patients (non-anhedonic group). A total of 50 female healthy controls were recruited during the same period.All participants were evaluated by the 17-item Hamilton depression scale (HAMD-17), Snaith-Hamilton pleasure scale (SHAPS), and the temporal experience of pleasure scale (TEPS), as well as voice acquisition.SPSS 23.0 software was used for data processing.Statistical analysis was conducted using one-way ANOVA, non-parametric tests, Logistic regression, and receiver operating characteristic curve.Results:Compared with the non-anhedonic group, the anhedonic group showed significant changes in 15 voice features(all P<0.05), including Mel-frequency cepstral coefficients, formant frequencies, intensity, and energy features.Among these features, Mel-frequency cepstral coefficients exhibited the highest accuracy in identifying anhedonic depression, with sensitivity of 47.5%, specificity of 91.9%, area under curve (AUC) of 0.751, 95% CI=0.686-0.866.Formant frequencies could identify female anhedonic depression, with a sensitivity of 90.0%, a specificity of 40.3%, an AUC of 0.647, and 95% CI=0.605-0.824.Energy features could identify anhedonic deficient depression, with a sensitivity of 60.0%, a specificity of 74.2%, an AUC of 0.679, and 95% CI=0.587-0.804.Intensity features could identify female anhedonic depression, with a sensitivity of 70.0%, a specificity of 58.1%, an AUC of 0.640, and 95% CI=0.554-0.769. Conclusion:Mel-frequency cepstral coefficients, formant frequencies, intensity features, and energy features may have specific changes in female patients with anhedonic depression.The Mel-frequency cepstral coefficients has the highest recognition accuracy for anhedonic symptoms in female depression patients, and is expected to become an objective evaluation index for female anhedonic depression.

Objective o investigate the clinical characteristics of middle cranial fossa arachnoid cyst (MCFAC) and its therapeutic effects with different surgical methods. Methods Three hundred and fifty-two patients with MCFAC (about 2.58% of patients with intracranial space occupying lesion),admitted to our hospital from May 2001 to May 2008, were chosen in out study; their clinical data,surgical approach and prognosis were analyzed retrospectively. The gender ratio of patient with MCFAC adopted resection of arachnoid cyst and arachnoid cyst-peritoneal shunt was performed in 28 patients.Results Follow-up was performed for 3 months to 3 years. The headache completely disappeared in 75 patients (58.59%) and partial remission in 41 (32.03%) after the operation. The frequency and degree of seizures obviously decreased in 8 of the patients with MCFIAC. Eleven patients with dystropy,attention-deficit disorder or difficulty of learning got improvement. The head circumference and local skull eminentia was stable. The cyst disappeared completely in 46 patients (13.07%), partially in 257 (73.01%) and no changes in 49 (13.92%). Conclusion The clinical features of MCFAC is that it mainly occur in the left side of male. The younger the patient with MCFAC is, the better the treatment effect in the surgical intervention is. good outcome can be achieved by resection of the parietal layer of arachnoid cysts. The indication of shunt with meso-low pressure shunt system is for larger arachnoid cyst.