Objective To explore the feasibility of nasolabial fold wrapped perforator flap in repairing pinna defects to produce the relative perfect appearance.Methods We treated 10 cases of pinna nasi defects by the nasolabial fold wrapped perforator flap.We examined the blood vessel distribution and exit of the blood vessel before surgery,and designed the nasolabial fold wrapped perforator flap according to the pinna defects.The flap with reasonable thickness was able to repair the both sides of defect after being cut properly.Meanwhile,the flap could be folded to form a local flap covered or lined with skin,and rotately transfered to repair nasal alar defect.Results All the flaps survived with incisions of donor sites healed primarily.Following up for 4 to 24 months showed that the color,texture and thickness of the flaps were similar to those of recipient sites.The scar in donor site was concealed and not obvious.Those cases who kept neurocutaneous branch had good sense.Satisfactory appearance was received without secondary repair.Conclusions The nasolabial fold wrapped perforator flap has abundant blood circulation and easily survives.It can also afford ample tissues to repair major area of pinna nasi defects,The blood vessel peduncle is too long to be survived easily.And the donor has not clear scar.Second reconstruction can be avoided in this procedure.The nasolabial fold wrapped perforator flap is one of the best choices to repair pinna defects.

Objective To study the risk factors of early complications and methods of treatment after pancreaticoduodenectomy(PD).Methods There were 79 patients who undercoent PD at our hospital between January 1998 and December 2007.All of the patients were divided into complication group and non-complication group according to the outcomes.Their clinical features,preoperative tests,and surgical factors were retrospectively analyzed.Results The postoperative complication rate was 58.2%,and the hospital mortality was13.9%.Logistic regression showed that the level of total bilirubin and liver function classification were the independent risk factors(P0.05).Conclusions The early complications after PD are closely related to the preoperative level of serum bilirubin and liver function.Proper periopertive management can effectively decrease the occurrence of pancreatic leakage and other postoperative compliccations.

Objective To explore the efficacy of radiofrequency ablation (RFA) combined with splenectomy in patients with small hepatocellular carcinoma (sHCC) associated with hypersplenism.Metheds The data of 100 patients with sHCC associated with hypersplenism who received RFA or hepatectomy combined with splenectomy were analyzed retrospectively.The patients were divided into the observation group and the control group based on the intraoperative approach.Fifty-three patients who received RFA and splenectomy were in the observation group,and the remaining 47 patients who received hepatectomy and splenectomy were in the control group.Multiple intraoperative and postoperative factors were compared between the two groups.Results There were significant differences between the two groups in warm ischemia time,operation time,intraoperative blood loss,hospital stay,and amount of blood transfusion (P ＜ 0.05).The postoperative complication rate of the observation group (7.6％,4/53) was significantly lower than the control group (44.7 ％,21/47) (P ＜ 0.05).There were no significant differences in 1-,3-,and 5-year survival (respectively,100.0％,75.5％,and 67.9％ vs 97.9％,76.6％,and 68.1％) and in disease free survival (96.2％,57.5％,and 41.7％ vs 93.5％,58.3％,and 43.8％ respectively) between the two groups (P ＞ 0.05).Conclusion RFA combined with splenectomy can be considered as an alternative treatment for patients with sHCC associated with hypersplenism.

Objectve To probe the effect of treating the trauma soft tissue defects of the leg by microsurgical technique. Methods Ninety-nine cases of the trauma soft tissue defects of leg were treated by used 12 kinds of microsurgical flaps.Result All cases with soft tissue defects of the leg were repaired successfully.Follow-up 6 months to 10 years,the results were satisfactory and function improvement in 99 cases. Conclusions Accoding to soft tissue defects of size,the section and the technique of the operator to select the different microsurgical flap could be suitable and resolvable problem of soft tissue defects.

Objective To investigate the effect of salvia miltiorrhiza (SM) on the expression of Bcl 2?Bax and hepatocyte apoptosis in hepatic preservation and reperfusion in a murine model.Methods The model of the preservation reperfusion of isolated rat liver was established. Bcl 2?Bax expression of the liver tissue and hepatocyte apoptosis were studied respectively by flow cytometry and in situ terminal deoxynucleotidyl transferase mediated dUTP FITC nick end labeling (TUNEL) technique. Results In SM treated group levels of Bcl 2 expression was significantly increased ( P

Objective To explore the elasticity of carotid artery in children with simple obese by echo tracking imaging technique.Methods Intima-media thickness (IMT), resistent index (RI), pulsatility index(PI ), the ratio of systolic phase and diastolic phase(S/D ) of common carotid artery (GCA) were detected differently in 50 simple obese children (obese group) and 50 normal children (control group) by CDFI.Internal systolic diameter (Ds), internal diastolic diameter (Dd),pressure-strain elastic moduhs(E ρ ), stiffness parameter ( β ), arterial compliance (AC), augmentation index (AI), pulse wave velocity ( PWV β ) were calcuhted automatically by means of echo tracking system.Results There was no significant difference in Ds,Dd,RI, PI,S/D and AI'between two groups (P >0.05).In obese group, IMT was significantly thicker,E ρ,β, PWV β were significantly higher,and AC was significantly lower thon those in control group (P < 0.05).Conclusions It has alteration of early atherosele in carotid artery of simple obese children.Echo tracking imaging technique is a quick, noninvasive, accurate and quantitative evaluating method for the elasticity of carotid artery.

AIM: To investigate the effect of microRNA (miR)-30c on the viability and migratory ability of human umbilical vein endothelial cells (HUVECs) by targeting plasminogen activator inhibitor-1 (PAI-1).METHODS:The HUVECs were transfected with miR-30c mimic and inhibitor or negative control (NC), and then the expression levels of miR-30c, PAI-1 mRNA and protein were detected by RT-qPCR and Western blot.The viability and migratory ability of HUVECs were measured by CCK-8 assay and wound healing test .After bioinformatic analysis, the assessment of miR-30c binding to PAI-1 3’-UTR was carried out using a luciferase reporter gene assay .RESULTS:miR-30c directly down-regu-lated PAI-1 levels by binding to the 3’ UTR seed sequence of PAI-1 mRNA.Furthermore, transfection of a miR-30c mimic down-regulated the expression of PAI-1 at mRNA and protein levels, leading to enhanced migratory ability and viability of the HUVECs.However, transfection of a miR-30c inhibitor up-regulated the expression of PAI-1 at mRNA and protein le-vels, leading to decreased migratory ability and viability .CONCLUSION:Regulation of miR-30c level changes the migra-tory ability and viability of HUVECs by affecting the PAI-1 expression, indicating the involvement of miR-30c in modulating endothelial function .

Objective To evaluate the preoperative nutritional status of patients with gastric cancer by using patient-generated subjective global assessment (PG-SGA) its relationship with postoperative results.Methods Make a preoperative nutrition assessment by using PG-SGA for 87 patients with gastric carcinoma who can be treated with operation.Analyze the effects of the postoperative complication,survival rate and the hospitalization time on patients.Results The number of patients of this group who can process the preoperative nutrition assessment by using PG-SGA accounts for 100％ of the total.There are 37 patients with moderate or severe malnutrition before operation (account for 39.1％).The complication incidence of patients with moderate or severe malnutrition before operation and the patients with no or mild malnutrition are 52.9％ and 5.7％ separately (P ＜ 0.01).The sensitivity and specificity of PG-SGA score for predicting complications are 85.7％ and 75.8％ respectively.And we should implement the analysis of regression to verify that the PG-SGA grade is the independent risk factor of postoperative complication by applying multiple Logistic(P ＜ 0.01).The average hospital stays of patients with moderate or severe malnutrition before operation and the patients with no or mild malnutrition are (21 ± 6) d and (16 ± 4) d separately (P ＜ 0.01).Conclusion According to the PC-SCA results,patients with moderate or severe malnutrition before operation have increased susceptibility to complication and the extension of hospital stays after the operatiou.Therefore,it is important to supply the proper nutrition support to these patients.

Objective To observe the impact of Aspergillus fumigatus conidia on the early apoptosis of alveolar epithelial cells.Methods A549 cells was first stimulated with tumor necrosis factor-α(TNF-α)or staurosporine (STS)to induce cell apoptosis,and then co-cultured with Aspergillus fumigatus conidia of three different concentrations (5 × 10 5 ,5 × 10 6 ,5 × 10 7 )simultaneously.The changes of the apoptosis rate of A549 cells were detected by flow cytometry.Results The early apoptosis of A549 cells was increased markedly after stimulated with TNF-α ([14.94 ± 0.82 ]% vs [3.26 ± 0.74]%,χ2 =9.18,P <0.05)and STS ([18.10±1 .00]% vs [3.26±0.74]%,χ2 =12.32,P <0.05). When Aspergillus fumigatus conidia of different concentrations were added,the apoptosis rate was decreased (χ2 =31 .23,P <0.05 ).The early apoptosis of A549 cells was negatively correlated with the concentration of Aspergillus fumigatus conidia (rTNF = - 0.92,r STS = - 0.94,both P < 0.05 ). Conclusion Aspergillus fumigatus conidia inhibits the early apoptosis of A549 cells induced by TNF-αor STS and the inhibit effect increases with the concentration of Aspergillus fumigatus conidia.

Objective To investigate the effect of portal hypertension (PH) on the activity of local renin angiotensin system(LRAS). Method The expression of local renin and local angiotensinogen mRNA in liver,splenic artery and vein of PH patients was detected with RT-PCR. Result Expression of local renin mRNA in the liver in control group was 0.19?0.12, significantly lower than that of splenic artery (0.45?0.12) and splenic vein (0.39?0.12) respectively(P