Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage,and to observe the outcome and summarize the possible complications.Methods A 6-7 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.A lancet shaped piece was used for dorsal augmentation,several cartilage bars for collumellar elevation and nasal tip elongation.Comprehensive structural rhinoplasty was then done with open rhinoplasty incision.Results 52 patients were treated with this method and satisfying aesthetic contouring of the nasal tip and dorsum was achieved.Among these patients,no such complications as implant extrution or dislocation,cartilage distortion,pneumothorax,hemothorax,infection or hemotoma were observed.The scar on the donor site was not obvius.Conclusions Costal cartilage can meet the demands of patients who consider prosthesis as an unacceptable option.For secondary revision rhinoplasties,costal cartilage provides sufficient materials to ensure a promising outcome with lower risk of infection and other complications.

Objective To investigate the expression and significance of nuclear transcription factor-?B(NF-?B) in childhood acute lymphoblastic leukemia(ALL) and the effect of dexamethasone(DEX) on its expression,to provide the experimental base for corresponding clinical treatment of the ALL,in which NF-?B is taken as a target.Methods 1.The biotin-streptavidin method was used to detect NF-?B P65 protein on 20 childhood ALL patients and 20 healthy children.2.The effect of DEX at clinically relevant dosage on NF-?B P65 protein were also detected by the biotin-streptavidin method.Results 1.The positive expression rate of NF-?B P65 protein in childhood ALL patients was 85.50%,obviously higher than that in normal group(10.0%)(?~2=22.56 P

Objective To explore the comprehensive approach of rhinoplasty using autologous costal cartilage and e-PTFE,and to observe the outcome and possible complications.Methods A 3-4 cm long costal cartilage was taken out mostly from the 6th or 7th rib and then divided into several parts and shapes.Structural reconstruction of the nasal tip was then done with these costal cartilage parts.Radix augmentation was conducted with e-PTFE.Results From Jan.2013 to Sept.2014,48 patients were treated with this method,all females,aged 22-35 years.36 of them had received rhinoplasty before,12 of them received none.Satisfying aesthetic contouring of the nasal tip and dorsum had been achieved in 45 patients.Deviation of the collumella and nostril asymmetry were found in 3 patients.Among all patients,no such complications as pneumothorax,hemothorax,infection,or hemotoma were observed.The scar on the donor site was not obvious.Conclusions Costal cartilage is sufficient,supportive and easily shapable,when applied to the structural reconstruction of the nasal tip,which can meet the demands of patients who prefer more outstanding and delicate nasal tip contouring.

Objective To explore the clinical effect of neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy for esophageal cancer.Methods The retrospective cohort study was conducted.The clinicopathological data of 111 esophageal cancer patients who underwent neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2010 and December 2016 were collected.Among 111 patients,68 with interval time between neoadjuvant chemo-radiation and thoracoscopic and laparoscopic three-incision esophagectomy ＜ 8 weeks were allocated into the ＜ 8 weeks group and 43 with interval time between neoadjuvant chemo-radiation and thoracoscopic and laparoscopic three-incision esophagectomy ≥8 weeks were allocated into the ≥8 weeks group.Patients underwent preoperative radiotherapy and chemotherapy with TP regimen,and then underwent selective thoracoscopic and laparoscopic three-incision esophagectomy.Observation indicators:(1) neoadjuvant chemo-radiation situations;(2) surgical and postoperative situations;(3) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Count data were analyzed using the chi-square test or Fisher exact probability.Comparison of ranked data was done by the nonparametric test.Results (1) Neoadjuvant chemo-radiation situations:all the patients underwent neoadjuvant chemo-radiation,without severe adverse reaction.Number of patients with complete remission based on oncopathology were 34 in the ＜8 weeks group and 15 in the ≥ 8 weeks group,with no statistically significant difference between the 2 groups (x2=2.441,P＞0.05).(2) Surgical and postoperative situations:all the patients underwent successful thoracoscopic and laparoscopic three-incision esophagectomy,with negative surgical margins.Operation time,volume of intraoperative blood loss,number of lymph node dissected,time of postoperative intrathoracic drainagetube removal,time of postoperative neck drainage-tube removal,hoarseness,upper gastrointestinal hemorrhage,anastomotic fistula,respiratory complication,pleural effusion and empyema,cardiovascular complication,incision abnormal healing,death within postoperative 30 days and duration of hospital stay were (354±103)minutes,(400± 76)mL,19±4,(11±4)days,(4.9±1.6)days,5,1,12,3,6,5,8,0,(19± 17) days in the ＜ 8 weeks group and (343±92) minutes,(392±51)mL,19±3,(12±6)days,(4.5±1.0)days,2,0,7,5,3,4,3,2,(18± 11) days in the ≥ 8 weeks group,respectively,with no statistically significant difference between the 2 groups (t =1.080,0.569,0.326,1.223,1.286,x2=0.029,0.035,1.114,0.000,0.000,0.246,t=0.315,P＞ 0.05).(3) Follow-up:90 of 111 patients were followed up for 3-82 months,with a median time of 25 months,including 55 in the ＜8 weeks group and 35 in the ≥8 weeks group.During follow-up,death and tumor recurrence were detected in 9,11 patients in the ＜8 weeks group and 6,11 patients in the ≥ 8 weeks group,respectively.Conclusion Neoadjuvant chemo-radiation combined with thoracoscopic and laparoscopic three-incision esophagectomy is safe and effective,and it doesn't increase the perioperative risks based on preoperative 8-week interval time.

Objective To summarize the clinical effect of urethroplasty using acellular dermal matrix patch for the treatment of anterior urethral stricture caused by lichen sclerosus.Methods The clinical data was analyzed retrospectively from 15 patients with anterior urethral stricture caused by lichen sclerosus treated with aeellular dermal matrix patch.Results The patients were followed up for 8-40 months.The urethral silicone stent was removed 4 weeks after operation in 15 cases and all the patients voided well 2 months after operation.The urinary peak flow rates ranged from 17.6 to 41.7 ml/s(mean,28.6ml/s).Urethral stricture occurred in 2 patients 3 months after operation undergoing discontinuous dilatation within 3 to 6 months,the patients voided very well.Conclusion It is feasible,safe and relatively simple to use acellular dermal matrix patch for anterior urethral stricture caused by lichen sclerosus.

Objective To analyze the clinical efficacy and technical key points of genioplasty for the deformities of the chin.Methods 153 patients with chin deformities were treated with the genioplasty,and the chin was moved in any direction,including sagittally,vertically and transversely;the key points of this procedure were summarized.Results There was no severe complication such as infection or nonunion observed.15 patients had ecchymosis and faded in 2 weeks;33 patients had hypaesthesia and recovered in 12 weeks.With the 12-24 months follow-up,all the patients healed well with satisfactory aesthetic results.Conclusions The genioplasty is a reliable and efficient method for the deformities of the chin,and it can significantly improve the appearance of the chin.

Aim To establish a LC-MS/MS method to measure the concentration of ginsenoside Rg1 in intrac-erebral dialysate and compare the probe recovery in vitro and in vivo. Methods The assay was conducted with a ACQUITY UPLC BEH C18(2. 1 mm × 50 mm, 1. 7 μm) . The mobile phase consisted of methanol and ultrapure water and it was detected by gradient elution. The flow rate was 0. 4 mL·min-1 . Specificity, linear range, precision and accuracy, stability were evaluated to investigate the reliability of the method. The recov-ery of ginsenoside Rg1 in probe in vitro and in vivo was compared. Results The retention time of ginsenoside Rg1 was 1. 91 min, the linear range was 0. 1 ~50 μg · L-1 , intra-day and inter-day precisions were less than 15%. The recovery of ginsenoside Rg1 was (4. 05 ± 0. 28)% in vitro and(26. 96 ± 4. 45)% in vi-vo. Conclusion The LC-MS/MS method is accurate, sensitive, and reproducible for quantitative determina-tion of ginsenoside Rg1 in microdialysate. The probe recovery of ginsenoside Rg1 in vivo is higher than in vitro, and both are stable in different concentrations.

Vigilance is defined as the ability to maintain attention for prolonged periods of time. In order to explore the variation of brain vigilance in work process, we designed addition and subtraction experiment with numbers of three digits to induce the vigilance to change, combined it with psychomotor vigilance task (PVT) to measure this process of electroencephalogram (EEG), extracted and analyzed permutation entropy (PE) of 11 cases of subjects' EEG and made a brief comparison with nonlinear parameter sample entropy (SE). The experimental results showed that: PE could well reflect the dynamic changes of EEG when vigilance decreases, and has advantages of fast arithmetic speed, high noise immunity, and low requirements for EEG length. This can be used as a measure of the brain vigilance indicators.
Attention ; Brain ; physiology ; Electroencephalography ; Entropy ; Humans ; Mathematics

Background Researches showed that wild-type p53(wtp53)and Rb94 genes inhibit the growth of retinoblastoma(RB),and these genes are involved in signal pathway in the induction and maintenance of cellular senescence.Thus the combination of two genes to inhibit growth of RB is concerned.Objective This study was to observe the inhibitory effect of the co-transfection of Rb94 and wtp53 gcnc into subretina on RB with ultrasound microbubble.Methods HXO-Rb44 suspension was subretinally injected to establish the RB model in 40 SPF female Balb/c nude mice.The RB models were randomized into model control group,wtp53 group,Rb94 group and wtp53+Rb94 group,and 0.1 ml relevant gene microvesicle suspension was injected via caudal vein in the different groups,but no any gene was used in the model control group.Seven days after modeling,followed by 0.5 W/cm2ultrasonic wave irradiated the eyeballs immediately for 4 seconds ×2 times and interrupted for 24 seconds.Eyeballs were extracted 7 days after gene transfection,and the expressions of wtp53 mRNA and Rb94 mRNA in tumor tissuc were detected by RT-PCR,and wtp53 and Rb94 protein in tumor tissue were assayed using Western blot.Immunochemistry was used to exam the VEGF expression,and TUNEL was used to evaluate the apoptosis of the tumor cells.Results The model successful rate after HXO-Rb44 suspension was 80％ (32/40)and obvious malformation cells were seen under the light microscope.In 7 days after gene transfection,no response band for wtp53 mRNA and Rb94 mRNA were found.The relative expression valuc of wtp53 mRNA was 0.65±0.07 in the wtp53 group,and that in wtp53+Rb94 group was 0.32±0.02,showing a significant difference between them (t =11.743,P =0.000).Rb94mRNA relative value was 0.42 ±0.03 in Rb94 group,and that in the wtp53 + Rb94 group was 0.23 ± 0.03,with a significant difference(t=5.041,P=0.001).The response bands of wtp53 and Rb94 proteins were seen in wtp53group,Rb94 group and wtp53+Rb94 group.Immunochemistry showed that the positive reactive intensity for VEGF in tumor tissue was obviously weaker in wtp53+Rb94 group than that in the wtp53 group,Rb94 group and model control group.Apoptotic index(Al) was 37.35±2.14 in the wtp53+Rb94 group,showing a significant increase in comparison with model control group (0.46 ± 0.05),wtp53 group (5.05 ± 0.80) and Rb94 group (6.43 ± 1.02) (t =-34.395,-28.206,-26.006,P＜0.01).Conclusions Ultrasound microvesicle enable double gene transfecting into RB tumor tissue,and Rb94 gene cooperation with wtp53 gene enhance the inhibitory effect on RB by promoting the apoptosis of RB cells.

Objectives: To evaluate the clinical significance of nuclear matrix protein 22 (NMP 22) in the detection of bladder transitional cell carcinoma (BTCC) and compare with voided urine cytology(VUC). Methods: A total of 69 cases with voided urine samples for NMP 22 and VUC test were included in this study. Thirty of them were BTCC patients(BTCC group) and twenty nine suffered from other urological diseases (nonbladder cancer group, NBC group). Ten were healthy volunteers (control group). Results: The NMP 22 values for BTCC group (67.3 U/ml) were significantly higher than that of NBC group(7.4 U/ml) and control group (4.3 U/ml)( P 0.05). NMP 22 was more sensitive than VUC in low grade BTCC(Ⅰ,Ⅱ)(62.50% vs 12.50%,P 0.05). Conclusions:Urinary NMP 22 is a useful marker for the early diagnosis of BTCC. It is more sensitive than VUC in low stage and grade BTCC.