OBJECTIVETo introduce the clinical experience in transplantation of the anterolateral femoral skin flap.

METHODSA total of 625 anterolateral femoral skin flaps in 600 patients were transplanted from 1988 to 2003. The retrospective analysis was carried out in all the cases as to the flap pedicle, the vascular variations, the surgical procedures and modifications, and the adaptation for a cutaneous-branch-absent flap.

RESULTSThe 625 flaps were transferred except 7 cancelled in the operation. Postoperatively, 17 cases encountered vascular complications, 10 of which survived completely with successful vessel exploration, 3 cases had partial necrosis, and 4 cases had complete necrosis. The survival rate was 97.8%. 545 flaps were pedicled with the descending branch or lateral branches; 45 flaps with the transverse branch or the high-site anterolateral cutaneous artery, 10 cases with the descending-transverse branch, 18 cases with other vessels. 7 cases were found cutaneous-branch-absent. The vessel variation rate of the flap was 4.06%.

CONCLUSIONSThe anterolateral femoral skin flap has less variation of its pedicle and high success rate of operation. It is an ideal choice for repair of soft tissue defects in the extremities.

Adolescent ; Adult ; Child ; Female ; Femur ; Humans ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Young Adult

OBJECTIVEThe study was designed to investigate the impact of non-dilated coronary artery wall lesion on myocardial perfusion.

METHODSDoppler tissue image (DTI) was used to measure regional ventricular wall motion in 43 Kawasaki children with non-dilated coronary arterial wall echocardiographic abnormalities (rough intima and arterial wall thickening) detected by two-dimensional echocardiography (2DE) at acute phase. A total of 31 cases who had both non-dilated coronary lesion and lowered ventricular wall motion velocity at subacute and convalescence phase underwent submaximal exercise single photon emitting computerized tomography (SPECT) for the evaluation of myocardial perfusion.

RESULTSIn 43 cases of Kawasaki disease with non-dilated coronary arterial wall abnormalities, 36 cases (83.7%) still had such lesions at subacute phase and 32 (74.4%)at convalescence. At the same time, lowered regional ventricular wall motion (RVWM) was found in 34 cases at subacute phase and in 31 cases at convalescence. DTI and 2DE had a very good correlation in the detection of such abnormalities (chi(c)2 = 9.64, P < 0.01 in subacute period, and chi(c)2 = 7.14, P < 0.01 in convalescence). In 31 cases accepting SPECT, 17 were positive. A total of 22 ischemic regions were detected. Eighteen out of 22 cases having ischemic regions had abnormal RVWM on DTI. SPECT ischemic regions were significantly in accordance with lowered RVWM in ventricular septum and anterior wall (chi(c)2=5.07 and 7.48, P < 0.05 and P < 0.01, respectively) noted in DTI.

CONCLUSIONNon-dilated coronary arterial wall abnormality is one of the forms of coronary artery wall lesions which could reduce myocardial flow perfusion. Its clinical significance is worthy of attention.

Child ; Coronary Artery Disease ; complications ; Echocardiography, Doppler ; Exercise Test ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; Myocardial Perfusion Imaging ; Tomography, Emission-Computed, Single-Photon ; Ventricular Dysfunction ; diagnosis ; etiology

OBJECTIVETo investigate the expression of brain-derived neurotrophic factor (BDNF) mRNA and immunoreactivity in experimental acute inflammatory brain injury.

METHODSTen rats were inoculated with pneumococcus to establish the model of bacterial inflammatory brain injury and other 6 rats were used as normal controls. At 24 h after inoculating, the expression of BDNF mRNA and BDNF protein in brain tissue was detected by in situ hybridization and immunohistochemical methods, respectively.

RESULTThe necrosis of neuron in cerebral cortex and hippocampus was observed after infection. The increase of BDNF mRNA expression in the cerebral cortex and hippocampus of experimental animals was demonstrated at 24 h after inoculation: (0.1194 +/- 0.02941 compared with 0.0662 +/- 0.01176)A and (0.1608 +/-0.01854 compared with 0.0680 +/- 0.00946)A (P<0.01), respectively. Compared with controls the expression of BDNF protein in the cerebral cortex and hippocampus was enhanced at 24 h of inoculation:(177.04+/-43.66 compared with 79.79+/-7.23)mm(2) (P<0.01) and (81.78 +/-37.47 compared with 42.98 +/-20.44)mm(2) (P<0.01), respectively. Strong positive hybridization and immunoreactivity were observed in the infiltrated inflammatory cell in leptomeninges, subarachnoid cavity, ventricles and brain parenchyma in the brain from the experimental rats.

CONCLUSIONThe expression of BDNF mRNA and BDNF protein increases following brain inflammatory injury, which supports the hypothesis that BDNF may constitute intrinsic neuroprotective mechanism as a part of the inflammatory response.

Acute Disease ; Animals ; Brain-Derived Neurotrophic Factor ; analysis ; genetics ; Calcium ; metabolism ; Female ; Immunohistochemistry ; Male ; Meningitis, Pneumococcal ; metabolism ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo evaluate the surgical approaches and therapeutic effect of lymphatic malformations located in head and neck in children.

METHODSEleven cases of lymphatic malformations in the region of head and neck in children encountered between Jan. 1998 and Dec.2008 in Peking University First Hospital were retrospectively analyzed. Initial diagnosis was made based on the physical examination and then confirmed by MR and Enhanced CT imaging. Surgical therapy was used for patients with lymphatic malformation which exceeds 4 cm. The operative technique was as follows: mass resection and superficial parotidectomy (4 cases), mass resection and total parotidectomy (2 cases), mass resection with neck dissection (2 cases), mass resection with neck dissection and sternotomy (1 case), marginal mandibular branch of facial nerve dissection and mass resection (2 cases). Dissection outside the false capsule was applied during the operation and facial nerve was dissected from bole to terminal arborization.

RESULTSThe mass was completely removed in all 11 cases without organ dysfunction and obvious disfigurement. The cure rate was 100%. Three cases suffered from a branch of facial nerve paralysis because of tension and 1 case had a Horner's syndrome after operation. One case needed a blood transfusion (150 ml) during the operation. All cases have been followed up with excellent results from 6 to 121 months, 32 months of the median, no mass recurrence.

CONCLUSIONSDissection outside the false capsule of mass and dissection of facial nerve were applied in the surgical treatment of huge lymphatic malformations. These methods are effective in the preservation of function and avoidance of abnormality.

Child ; Child, Preschool ; Female ; Head ; Humans ; Infant ; Lymphatic Abnormalities ; surgery ; Male ; Neck ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo detect the infection of human papillomavirus (HPV) 16/18 in patients with head and neck squamous cell carcinoma and explore the relationship between HPV infection and expressions of Ki-67 and P53 proteins in tumor tissue.

METHODThe level of HPV 16/18 DNA was measured by real time polymerase chain reaction, and Ki-67 and P53 proteins were measured by immunohistochemistry in tissues from head and neck squamous cell carcinoma.

RESULTSHPV 16/18 DNA was detected in 62.8% of our patients. In each cancer tissue sample, Ki-67 protein was expressed between 2% to 70%. P53 protein was expressed in 46.15% of our patients. No significant relation was found between HPV 16/18 DNA level and sex, smoking, drinking, and tumor clinical stages. However, level of HPV 16/18 DNA was found to have positive relation with tumor pathological grades and negative relation with P53 protein expression. No relation with Ki-67 protein expression was found.

CONCLUSIONHead and neck squamous cell carcinoma may be initiated by HPV 16/18 infection and the mechanism in carcinogenesis involves abnormal expression in P53 protein.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; virology ; DNA, Viral ; analysis ; Female ; Human papillomavirus 16 ; isolation & purification ; Human papillomavirus 18 ; isolation & purification ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Tumor Suppressor Protein p53 ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; virology

OBJECTIVETo explore the feasibility of the treatment of hypospadias with penile and scrotal skin flaps.

METHODSTwenty-three hypospadias patients aged 3.5-19 (mean 6. 8) years underwent urethroplasty with penile and scrotal skin flaps. All were followed up for 6 years and analyzed retrospectively.

RESULTSOf the total number of patients, 21 (91.3%) succeeded in one operation and the other 2 developed complications, including urethral fistula and urethral structure.

CONCLUSIONPenile and scrotal skin, advantageous for its adequacy, rich blood supply and contribution to high success rate of surgery, is believed to be the first choice for urethroplasty in the treatment of hypospadias.

Adolescent ; Adult ; Child ; Child, Preschool ; Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Retrospective Studies ; Scrotum ; surgery ; Skin Transplantation ; Surgical Flaps

OBJECTIVETo compare the differences between the direct immuno-fluorescent assay (DFA) and real-time quantitative PCR in detecting the Hantavirus (HV) in rat lungs.

METHODSFrom April to October in 2012, a total of 479 rats were caught by mouse-trap in residential or wild areas in Huxian, Jingyang, and Meixian of Shaanxi province, where haemorrhagic fever with renal syndrome (HFRS) was highly prevalent. The rats were dissected to take the two lungs, one was frozen and applied immuno-fluorescent assay to detect HV antigen while the other one was extracted its RNA and detected HV nucleic acid by real-time quantitative PCR. Then we compared the positive rate of the two methods.

RESULTSOut of the 479 rats, 105 were caught from residential areas and the other 374 were caught from wild areas. Among the 105 rats caught from residential areas, no HV were detected out neither by DFA nor by real-time quantitative PCR. Among the 374 wild rats, 13.1% (49/374) were detected HV positive by DFA and 14.7% (55/374) were detected HV positive by real-time quantitative PCR. The difference showed no statistical significance (χ(2) = 0.402, P = 0.526). When detecting each lung sample, the HV positive rate was 10.2% (49/479) under the detection by DFA while the HV positive rate was 11.5% (55/479) under the detection by real-time quantitative PCR. The difference had no statistical significance (χ(2) = 1.286, P = 0.257) and the consistency coefficient was 68.2% under the paired chi-square test analysis, which showed high consistency (u = 11.759, P < 0.05). The sensitivity of real-time quantitative PCR to detect HV was 77.6% (38/49) comparing with DFA as standard, and the specificity was 96.1% (413/430). Out of the 9 suspected HV positive sample detected by DFA, 6 were confirmed positive by real-time quantitative PCR and 3 were denied.

CONCLUSIONCompared with the DFA, real-time quantitative PCR could also be used to detect the infection of HV in rats, and the result might be more stable.

Animals ; Fluorescent Antibody Technique, Direct ; Hantavirus ; isolation & purification ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; prevention & control ; Lung ; virology ; Rats ; Real-Time Polymerase Chain Reaction

OBJECTIVETo compare the postoperative hemorrhage between standard uvulopalatopharyngoplasty (UPPP) and coblation assisted UPPP, and to evaluate the related risk factors and preventive measures.

METHODSFive hundreds and ninety seven patients with obstructive sleep apnea hypopnea syndrome (OSAHS) underwent UPPP and coblation assisted UPPP between January 1, 1999, and September 30, 2009 were reviewed retrospectively. Two hundred and sixty three patients with coblation assisted UPPP and 334 patients with standard UPPP were treated respectively. Single factor statistic analysis, multiple factors Logistic regress statistic analysis and Wilcoxon test method for related risk factors were applied.

RESULTSA total of 42 patients (7.0%) experienced postoperative bleeding. Among them, 24 patients with coblation assisted UPPP (9.1%) and 18 patients with UPPP (5.4%) had postoperative hemorrhage. Significant difference was not found in the degree of hemorrhage (z = 0.784, P > 0.05), hemorrhage site(χ(2) = 1.387, P > 0.05) and postoperative hemorrhage rates (χ(2) = 3.14, P > 0.05) between the two surgical techniques. Significant difference was found in the interval of hemorrhage after surgery between the two surgical techniques (χ(2) = 9.25, P < 0.01). History of hypertension, smoking, hepatic dysfunction was found to be correlated with the postoperative hemorrhage (Odd-ratio were respectively 7.326, 3.674, 2.707).

CONCLUSIONCoblation technique did not significantly increase UPPP postoperative hemorrhage.

Adult ; Catheter Ablation ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; methods ; Palate ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Postoperative Hemorrhage ; etiology ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Uvula ; surgery ; Young Adult

Adolescent ; Adult ; Female ; Humans ; Male ; Mercury ; urine ; Middle Aged ; Reference Values ; Spectrophotometry, Atomic

Bat is nature reservoir hosts of some important viruses.It has been confirmed that bats were infected by many viruses in nature in Yunnan Province,China during 2010-2015,such as SARS-like coronavirus and another coronaviruses (Alphacoronavirus and Betacoronavirus) as well as novel reovirus,rotavirus,orthohepadnavirus,filovirus,paramyxovirus,adenovirus,bocavirus and circovirus.This paper presents a review about natural infection of bat with zoonosis-related viral pathogens in Yunnan Province,China,and its public health importance.