Objective To explore and use a simple effective technique for repairing whistling de-formities and similar defects of upper lip.Methods According to various degrees of the defect on the ver-milion,one or two lip flaps were designed.At the first,a horizontal incision was performed in the area of vermilion defect to make the wound as a recipient area,then one or two lip flaps were formed,which were vertical against horizontal incision and close to area of deformity.Lengths of the flap ranged from 0.6 to 1.4cm,widths of the flap ranged from 0.4~0.7cm,and maximum ratio of length to width was 3:1.At last,the lip flaps were rotated up to recipient area for repairing whistling deformities.Sometimes deform-ities of Cupid’s bow and white lip were repaired at the same time through making additional incision.Re-sults Follow-up for l to 15 months showed that 25 cases of operation were with satisfactory results,ver-milion deformities were repaired or acquired visible improvement without complications and without leav-ing clear incision scar at lip after operation from November 2002 to September 2004.Conclusion In gen-eral application of vertical lip flaps could achieve anticipatory objective for repairing the whistling deformi-ties on lip if there are sufficient membraneous tissue in donor area.This operation is simple,practical and satisfactory.

OBJECTIVETo observe the therapeutic effect of expanded supraclavicular island flaps for facial and cervical scar.

METHODSFrom Oct. 2010 to Nov. 2013, a series of 16 patients with facial and cervical scars were treated by the expanded supraclavicular island flaps, pedicled by the supraclavicular cutaneous branch of transverse cervical artery. In the first stage, the soft tissue expanders (ranging from 400 ml to 600 ml in volume) were implanted in the anterior thoracic region. In the second stage, the facial and cervical scars were removed and the contructures were released, the expanded flap was transferred to cover the defects. The wounds at the donor sites were closed directly.

RESULTSThe flaps size ranged from 12 cm x 7 cm to 22 cm x 11 cm. All flaps survived with no flap necrosis. Hematoma occurred in one case and healed by debridement. 16 patients were followed up for 3-12 months. The color and texture of all flaps matched well with the surrounding skin tissue, no bulky appearance or hypertrophic scar were noticed.

CONCLUSIONSThe expanded supraclavicular island flap is a good choice for repairing facial and cervical scar. The appearance and function can be improved.

Cicatrix ; surgery ; Face ; surgery ; Humans ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; transplantation ; Thoracic Wall ; Tissue Expansion Devices

Objective To investigate the factors associated with radiation-induced lung damage in non-small cell lung cancer (NSCLC) treated with radical three-dimensional conformal radiotherapy (3DCRT). Methods Eighty-six patients with NSCLC were treated by radical 3DCRT (total dose 60-66 Gy, 1.8-2.0 Gy/f, 5 d/w). Several clinical and dosimetric factors were analyzed retrospectively, inclu-ding sex, age, smoking history, heart disease history, pulmonary function, tumor location, clinical stage,pathological diagnosis, chemotherapy, total dose, numbers of fields, mean lung dose (MLD), V_5, V_(10),V_(15), V_(20), V_(25), V_(30), V_(35), V_(40), V_(45), V_50, V_55, V_(60) and V_(65). Radiation-induced lung damage was graded ac-cording to the Common Terminology Criteria for Adverse Events version 3.0. Univariate and multivariate an-alyses were performed to identify the predictive factors. Results The median follow-up was 12 months (range, 1-36 months). The incidence of≥ grade 3 radiation-induced lung damage was 13.9%. In univari-ate analysis, V_5, V_(10),V_(15), V_(20), V_(25), V_(30), V_(35)and MLD were all significantly associated with radiation-induced lung damage, while the clinical factors, total dose, numbers of fields, V_(40), V_(45), V_50, V_55, V_(60)and V_(65) were not. In Logistic regression analysis, Vs was the only factor significantly associated with radiation-induced lung damage (χ~2=5.15,P=0.023). The incidence of ≥ grade 3 radiation-induced lung damage in the group with V_5≤45% and V_5 > 45% were 2.3% and 26.2%, respectively (χ~2= 10.24, P = 0.001). Conclu-sions The lung damage may dependent on the irradiated volume more than the radiation dose. A number of doaimetric factors are significantly associated with radiation-induced lung damage. However , V_5 should be considered in radical 3DCRT for NSCLC patients to reduce the incidence of radiation-induced lung damage.

Objective To determine the optimum dose of dexmedetomidine administered locally through evaluating the effects of different doses of dexmedetomidine on the median effective concentration (EC50) of ropivacaine for brachial plexus block.Methods American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 19-50 yr, weighing 50-80 kg, scheduled for elective ulna and radius fracture open reduction and internal fixation, requiring ultrasound-guided axillary brachial plexus block, were randomly assigned into 4 groups using a random number table: control group (group C) and dexmedetomidine 0.4, 0.6 and 0.8 μg/kg groups (D1 , D2 and D3 groups).Axillary brachial plexus block was performed only with ropivacaine in group C.In D1-3 groups, axillary brachial plexus block was performed with the mixture of ropivacaine and dexmedetomidine 0.4, 0.6 and 0.8 μg/kg, respectively.The effective block was defined as complete loss of pain sensation in the areas innervated by the brachial plexus.The volume of local anesthetics was 40 ml.The concentration of ropivacaine was determined by up-and-down technique.The initial concentration was 0.4％ and the ratio between the two successive concentrations was 1.0.If the block was effective, the next patient received a lower dose of ropivacaine;or conversely if ineffective, a higher dose was given in the next patient.At least 7 independent crossover pairs were observed in each group.The EC50 of ropivacaine was the mean of the concentration of ropivacaine of each crossover pair.The occurrence of brachial plexus block-related adverse events, adverse cardiovascular events and over-sedation was recorded.Results In C, D1, D2 and D3 groups, 20, 22, 24 and 19 patientswere enrolled, respectively.Compared with group C, the EC50 of ropivacaine was significantly decreased in D2 and D3 groups, and no significant change in the EC50 of ropivacaine was found in group D1.No patients developed adverse events in group D1.The incidence of bradycardia was 17％, but it was transient in group D2.In group D3, the incidence of bradycardia and hypotension was 58％ and 32％, respectively, and they required special treatment, and the incidence of over-sedation was 10％.Conclusion The optimum dose of dexmedetomidine is 0.6 μg/kg when mixed with ropivacaine for brachial plexus block.

Objective To study the changes of anticoagulation and fibrinolysis in neonatal respiratory distress syndrome(NRDS).Methods The levels of plasma protein C(PC),total protein S(TPS),antithrombin Ⅲ(AT-Ⅲ), D-Dimer(D-D) and von Willebrand factor(vWF) were measured with ELSIA assay and immunoturbidimetry in 27 cases NRDS, 20 cases prematures and 15 cases full-term newborns as normal controls.Results The levels of PC, TPS and AT-Ⅲ were lower, but the levels of D-D and vWF were significantly higher than those of prematures and normal controls.The PC,TPS of prematures were lower than normal controls otherwise there is no difference of AT-Ⅲ,D-D,vWF between prematures and normal controls. Conclusions There exists the activation of anticoagulation and fibrinolysis and the injury of vascular endothelium in critical NRDS, and they are early sensitive indexes for the diagnosis of disseminated intravascular coagulation(DIC).

95 mL/L O2) for 2 hours.The gross anatomical and histological changes(HE staining)in lungs were observed,VEGF mRNA expressions were studied by reverse transcription polymerase chain reaction(RT-PCR).Results Lungs of experimental groups represented edema,inaddition,punctiform,local and diffuse pulmonary hemorrhage were observed in groups of HH,HHR and HHRO2.Histopathological changes included pulmonary alveoli and interstitial edema,spacer breaking,pulmonary alveolidilating,fusion and hemorrhage,in which the most severe cases involved in group HHRO2.VEGF 188 mRNA expression increased significantly in group H and HH(P

950 mL/L for 2 hours.Gross anatomical changes and histological changes(HE staining)of lungs were observed,VEGF expression was detected by immunohistochemical method.Results Two rats in hypothermia-hypoxia group and 4 rats in rewarming-reoxygenating group died while none in control group.Lungs of hypothermia-hypoxia group and rewarming-reoxygenating group represented edema and punctiform,local and diffuse pulmonary hemorrahge.Histopathological changes included pulmonary edema,alveolar septum broken,pulmonary alveoli fusion and pulmonary hemorrahge.More severe pathological change could be found in rewarming-reoxygenating group.Optical density value of VEGF expression in 3 groups were 0.29?0.06,0.36?0.05,0.22?0.05,respectively,there were significant diffe-rences of VEGF expression between 3 groups(F=15.64 P

This study was aimed to investigate the effect of dexamethasone (Dex) on immunosuppressive ability of mesenchymal stem cells (MSC) during expansion and differentiation of MSC. MSC were cultured in 96-well flat-bottom plates. Proliferation assays were performed by using the BrdU colorimetric ELISA Kit. To explore the effect of Dex on MSC immunosuppressive ability, MSC were firstly cultured in complete culture medium for 14 d with Dex (10 nmol/L), and then, peripheral blood mononuclear cells (PBMNC) were co-cultured with MSC in 96-well flat-bottom plates for 3 d. Phytohemagglutinin A (PHA, 10 µg/ml) was used to stimulate activation of PBMNC. The concentrations of IFN-γ in culture supernatants was detected by ELISA. The results indicated that there was no obvious difference in representative phenotypes of MSC between experimental and control groups after MSC were treated with low concentration of Dex (10 nmol/L) for 14 d, but the suppression of Dex-treated MSC on lymphocyte activation in same concentration of cells was significantly reduced as compared with control group. After the Dex-treated MSC were co-cultured with IFN-γ for 12 h, the immunoregulatory ability of MSC was recovered in a certain degree. It is concluded that the Dex impairs the immunosuppressive ability of MSC, the IFN-γ can protect and reverse the immunosuppressive ability of MSC impaired by Dex, so that, when the immunoregulatory activity of MSC is investigated, it is necessary to avoid adding Dex in the culture medium.
Cells, Cultured ; Dexamethasone ; adverse effects ; Humans ; Immune Tolerance ; drug effects ; Interferon-gamma ; immunology ; Leukocytes, Mononuclear ; Lymphocyte Activation ; immunology ; Mesenchymal Stromal Cells ; cytology ; drug effects ; immunology

Objective To investigate the renal expression changes of microRNA-215(miR-215) and its role in diabetic nephmpathy of type 2 diabetic db/db mice. Methods Fourweek-old diabetic db/db mice and norml control group non-diabetic db/m mice were selected.Real-time PCR was used to detect the relative level of miR-215 at the age of 8,12 and 16 weeks.Catenin beta interacting protein 1 (CTNNBIP1) mRNA and protein level were measured by realtime PCR,WesteRN blotting and immunohistochemisty.A lueiferase reporter assay was used to determine whether CTNNBIP1 was a direct target of miR-215. Results (1)With the growth of db/db mice,the major pathological characteristics of kidney included glomerular hypertrophy,segmental mesangial cells proliferation and mesangial matrix expansion.(2)Compared with the db/m mice,the db/db mice of 8,12 and 16 weeks showed obvious increase in body weight(BW),blood glucose (Glu) and 24 hour urinary albumin excretion (UAE) (P＜0.05,respectively).(3)Compared with the db/m mice,special miR-215 was highly expressed in the kidney of db/db mice and was up-regulated significantly according to the development of DN (P＜0.05).(4)The mRNA and protein expression of CTNNBIPl of kidney were consistently down-regulated in db/db mice than those in controls (P＜0.05,respectively). (5)By luciferase reporter,miR-215 could negatively regulate CTNNBIP1 gene by targeting its 3'-UTR sequence (P＜0.01). Conclusion High expression level of miR-215 plays a potential role in the initiation and progression of DN by down-regulating the expression of CTNNBIPl.

Autopsy ; China ; epidemiology ; Congenital Abnormalities ; epidemiology ; etiology ; mortality ; Folic Acid ; adverse effects ; Humans ; Infant, Newborn ; Survival Rate ; Ultrasonography, Prenatal ; adverse effects