OBJECTIVE: To observe the short-term and long-term curative effect of the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer) application used in the 82 cases postoperative tissue shortage repair that after the head neck carcinoma resection. METHOD: To held the 82 cases head neck carcinoma postoperative mucosa shortage repaired after resection by the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer), 65 cases mucosa shortage wound be directly covered by the repair membrane and the other 17 cases mucosa shortage wound be repaired by the tranfered muscle tissue flap with the repair membrane covered; 53 cases underwent additional postoperative radiotherapy between 2-4 weeks and follow-up in 1, 3, 6, 12, 18, 24, 30, 36, 48, 60 months and observed the operation site repair process through the electronic laryngoscope, observed the patients respiration, swallow, phonation function. RESULT: Seventy-seven cases patients operation incision reached I phase healing standard, another 5 cases patients operation incision reached II phase healing standard because of the wound infection and fully-recovered through the local wound drainage,dressing process. All the patients tracheal cannula,the stomach tube be extubated successfully and without the local cicatricial constriction occurred. Seventy-eight cases follow up period reached 1 year including 53 cases who underwent postoperative radiotherapy, 49 cases follow up period reached 3 years including 32 cases who underwent postoperative radiotherapy, 14 cases follow up period reached 5 years including 12 cases who underwent postoperative radiotherapy. The patients with static local lesions discovered no reaction such as exclusion, allergy. CONCLUSION The application of xenogenic acellular dermal matrix membrane (or joint muscle flap transfer used in in the postoperative tissue shortage repair that after the head neck carcinoma resection have several advantage such as comparatively easily implementation, operation safety edge enough,well preserved organ function, comparatively low incidence about the laryngeal stenosis, the short-term and long-term repair effect are all exact.
Acellular Dermis ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Female ; Head and Neck Neoplasms ; radiotherapy ; surgery ; Humans ; Male ; Mucous Membrane ; surgery ; Postoperative Period ; Squamous Cell Carcinoma of Head and Neck ; Surgical Flaps ; transplantation ; Wound Healing

【Objective】 To study the effect of Salidroside(Sal) on platelet activation and aggregation and the interaction between human platelets and MDA-MB-468 cells of breast cancer. 【Methods】 Human platelets were collected, platelet suspension was prepared, and platelets were treated with different concentrations of Sal. The effects of Sal on platelet activation and aggregation were detected by thromboelastogram(TEG) and flow cytometry. Breast cancer MDA-MB-468 cells were cultured in vitro, and human platelets were treated with different concentrations of Sal, and then activated by thrombin. The effects of Sal on the interaction between platelets and MDA-MB-468 cells were analyzed by adhesion test and scratch test. 【Results】 TEG detection: The ADP inhibition rate in the blank control group was (10.97±12.69)%, and the ADP inhibition rate in all Sal intervention groups was higher than that in the blank control group (P<0.05). The AA inhibition rate was (8.11±7.84)% in the control group and (25.96±15.18) % in the 5 μmol/L Sal intervention group, and the difference was statistically significant (P<0.05).Flow cytometry: The expression of CD62P on platelet surface in 40 and 60 μmol/L Sal groups was (56.5±0.17)% and (65.50±0.36)%, respectively, and the difference was statistically significant compared with the positive control group (76.53±0.49)% (P<0.05). The percentages of PAC-1 expression on platelet surface in 40 and 60 μmol/L Sal groups were (62.20±0.10)% and (58.47±0.15)%, and the difference was statistically significant compared with the positive control group (72.10±0.20) % (P<0.05). Adhesion experiment: Platelets can have adhesion with MDA-MB-468 cells, and activated platelets have stronger adhesion ability. The adhesion rate in the Sal group was significantly lower than that in the positive control group, and was negatively correlated with the concentration of Sal. Scratch test: The cell mobility at 24 h in the positive control group was (12.71±0.70)%, and the cell mobility in each Sal treatment group was (4.51±0.44)%, (3.85±0.11)%, (5.37±0.36)%, (4.15±0.13)% and (3.55±0.38)%, respectively, showing significant decrease compared with the positive control group(P<0.05). After 48 h of Sal treatment, the cell mobility of 10, 20, 40 and 60μmol/L Sal groups decreased, and there was a statistical difference compared with the positive control group(P<0.05). 【Conclusion】 Sal can inhibit the adhesion between activated platelets mediated by thrombin and MDA-MB-468 cells and the migration of MDA-MB-468 cells.

【Objective】 To investigate the effect of leukocyte filter in removal of tumor cells in blood and the viability of using leukocyte filter in intraoperative cell salvage in tumor patients. 【Methods】 The leucocyte-depleted suspended RBCs prepared from 200 mL human whole blood were spiked with HCT116 cells cultured in vitro to simulate the autologous blood recovered from tumor patients during operation. Conventional filter (group A, n=6), filter with small pore size (group B, n=6) and filter with thicker membrane and small pore size (group C, n=6)) were used. The CD45^-EpCAM⁺ tumor cells were detected by anti-CD45-PE and anti-CD326 (EpCAM)-FITC flow cytometry, and the absolute count of tumor cells were calculated using Flow Count fluorescence microspheres. The activity of tumor cells was detected by cell culture and trypan blue staining. Furthermore, blood biochemical indexes (LDH, K⁺ ) and red cell recovery rate were detected. 【Results】 Tumor cell counts before and after the application of leukocyte filter A, B, C were(1.52±0.48)×10⁷/mL vs(2.73±1.74)×10⁴/mL, (1.48±0.55)×10⁷/ml vs(2.96±1.85)×10⁴/mL and (1.44±0.46)×10^7/mL vs(3.08±2.33)×10⁴/mL, respectively (P >0.05), which was significantly reduced after filtration (P < 0.01). No viable cells were found in the filtered blood cultured for 7 days. There were no significant differences in K⁺ and LDH value before and after filtration among the three groups(P >0.05). The blood recovery rates of group A, B, C were 85.22%, 84.97% and 82.86%, respectively. 【Conclusion】 The conventional filter can significantly reduce the number of circulating tumor cells, and it is feasible for intraoperative cell salvage in tumor patients.

【Objective】 To investigate the feasibility of allogeneic platelet-rich plasma (PRP) for the treatment of herpes zoster wounds secondary to systemic lupus erythematosus (SLE), especially large ulcer wounds. 【Methods】 The treatment process of a patient with massive herpes zoster wounds in perineum and hip accompanied by extensive soft tissue necrosis secondary to SLE was retrospectively analyzed. The clinical efficacy of allogeneic PRP was explored combined with treatment key points and literature review. 【Results】 The patient′s wound bed was prepared until the wound was fresh, then treated externally with allogeneic PRP 3 times a week. The wound was healed completely after 42 days. 【Conclusion】 In the case of autologous PRP unavailable or unsuitable, allogeneic PRP is a safe alternative, which can effectively promote tissue regeneration, and this patient achieved curative effect in a short period of time.

Objective: To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in patients with diffuse large B-cell lymphoma (DLBCL). Methods: Thirty-two patients (22 males, 10 females, age: 22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak filling rate (PFR), summed motion score (SMS) and summed thickening score (STS) as well as left ventricular systolic synchrony indicators including phase bandwidth (BW), phase standard deviation (SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ² test were used for data analysis. Results: Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8.68)°; SD: (11.65±4.64)° vs (8.79±3.14)°; entropy: (39.84±5.51)% vs (36.19±5.94)%; t values: -9.132 to -3.173, all P<0.05). There were no significant differences in other indicators (t values: -1.161 to 1.750, z values: -1.633 to -0.096, all P>0.05). Of 32 patients, 13 patients (40.62%) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchrony was significantly higher than that of left ventricular dysfunction (15.62%, 5/32; χ²=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssynchrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)% vs (66.79±7.65)%; t=4.087, P<0.01). Conclusion Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indicator of cardiotoxicity caused by anthracycline chemotherapy.