In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years (14-83 years) and with a medium follow-up period of 18 months (12-24 months). Of all the cases of acute trauma, there were 10 cases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes (2 cases), advanced age (>65 years, 3 cases) and cigarette smoking (6 cases). The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites.

3 month),fluid sign was observed in 2(3 vertebrae,3/26,11.5%). Conclusion Fluid sign is characteristic in acute,subacute and early chronic trauma vertebral compression fracture for bone marrow edema,while it is rare in metastatic tumor vertebral compression fracture.It may paly a role in the differentiation of benign and malignant vertebral compression fracture.

OBJECTIVETo identify the predictors of the positive results of transrectal ultrasound (TRUS)-guided biopsy for prostate cancer.

METHODSWe performed univariate and multivariate logistic regression analyses on the relevant data on 385 male patients that underwent TRUS-guided biopsy for prostate cancer, including such potential predictors as age, body mass index (BMI), symptoms, results of digital rectal examination (DRE), tPSA, fPSA, free/total PSA ratio (f/tPSA), prostate volume (PV), and PSA density (PSAD) for identification of the risk factors related to the positive rate of biopsy. Then we constructed a scoring system as a tool for predicting prostate cancer in repeat biopsies and determined the sensitivity of the system by calculating the false positive rate using the receiver operating characteristic curve.

RESULTSAmong the 385 patients, 139 (36.1%) were diagnosed with prostate cancer. On multivariate analysis, age (P < 0.01), DRE (P < 0.01), tPSA (P < 0.01), fPSA (P < 0.01), f/tPSA (P < 0.01), PV (P < 0.01), and PSAD (P < 0.01) were all significant predictors of prostate cancer. Multivariate logistic regression analysis showed age, tPSA, f/tPSA, PV, and PSAD to be independent predictors, with ORs and 95% CIs of 1.07 (1.05-1.16), 1.05 (1.02-1.15), 0.97 (0.86-0.99), 0.98 (0.87-0.96), and 1.79 (1.48-2.06), respectively. Moreover, patients with the risk score of 3-5 had a significantly higher rate of prostate cancer than those with 0-2 (64% vs 11%, P < 0.001).

CONCLUSIONThe scoring system on the key predictors of prostate cancer can help urologists to identify the men in need of prostatic biopsy.

Aged ; Digital Rectal Examination ; Humans ; Image-Guided Biopsy ; methods ; Logistic Models ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; chemistry ; pathology ; ROC Curve ; Risk Factors ; Ultrasonography, Interventional ; methods

OBJECTIVETo investigate the surgical approaches for sinonasal tumors with intracranial extension.

METHODSSeventeen patients with intracranial invasion tumors were treated surgically by maxillectomy combined with frontal or infratemporal approaches in 11 cases, including squamous cell carcinoma 8 cases, papillocarcinoma 2 cases and meningioma 1 case. Nasofrontal bone translocation in 1 case which was a meningioma case, craniofacial approaches in 5 cases, including squamous cell carcinoma 4 cases and esthesioneuroblastoma 1 csae.

RESULTSOne of two meningioma cases with cavernous sinus invasion was incompletely resected, another case was resected en bloc. In malignant group, ten cases were treated by nasomaxillectomy combined with frontal or infratemporal approaches. One patient died 1 year after operation, 7 cases survived for over 3 years, and 5 for over 5 years. Five cases were treated by craniofacial approach, among them, one patient died 6 months after operation, 4 cases survived for over 3 years, and 2 for over 5 years. All patients healed smoothly.

CONCLUSIONSMaxillary nasopyramid translocation combined with frontocranial or infratemporal approach is available for en bloc removal of sinonasal tumors with intracranial extension. The nasofrontal bone translocation is available for removal of tumors with limited intracranial extension and well developed frontal sinus. Cranioanterolateral facial approach is suitable for nasocranial tumors with facial bone involvement.

Brain Neoplasms ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; pathology ; surgery

OBJECTIVEThis study compared the roughness of porcelain polished or glazed surfaces and the adhesion of oral streptococcus mutans to them in vitro.

METHODS30 porcelain samples were made. Porcelain samples in group A were polished with diamond paste. Porcelain samples were glazed in group B and were polished with Al2O3 (240#) bur in group C. Their roughness values were measured by profilometer. Standardized cell suspensions were incubated with test samples for one hour at 37 degrees C, then retained cells were counted by image analysis (percentage area of a microscopic field covered by cells).

RESULTSRoughness values of group A, B, C were respectively (0.1987 +/- 0.057) microm, (0.1990 +/- 0.091) microm, (0.4260 +/- 0.174) microm. There was no significantly difference between group A and group B. The roughness samples in group C were significantly rougher than that in the other groups. The amount of retained cells in group A, group B, group C was respectively (15.92 +/- 4.37)%, (16.39 +/- 6.31)% and (41.48 +/- 12.1)%. There was no significant difference between the cell adhesion on porcelain surface glazed and polished, but more bacteria adhered on the porcelain surface in group C.

CONCLUSIONSPorcelain surface polished treatment was clinically acceptable compared with its glazed. They all exhibited the least amount of bacteria adhesion. The more porcelain surface was rough, the more bacteria adhered on it.

Bacterial Adhesion ; Dental Polishing ; Dental Porcelain ; Humans ; Streptococcus mutans ; physiology ; Tooth ; microbiology

The efficacy of neoadjuvant chemotherapy and adjuvant chemotherapy on stage IIb nasopharyngeal carcinoma(NPC) remains unclear. Conventional two-dimensional radiotherapy combined with concurrent chemotherapy can improve the overall survival, progression-free survival, recurrence-free survival, and distant metastasis-free survival of patients with stage IIb NPC. Intensity-modulated radiotherapy without concurrent chemotherapy also provides good outcomes for patients with stage IIb NPC. This article summarizes the features of stage IIb NPC and reviews the role of chemotherapy in this subgroup of NPC.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma ; Chemoradiotherapy ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Fluorouracil ; administration & dosage ; Humans ; Nasopharyngeal Neoplasms ; pathology ; therapy ; Neoadjuvant Therapy ; Neoplasm Staging ; Radiotherapy, Intensity-Modulated

The purpose of this study is to investigate the preparation of hydroxycamptothecine (HCPT)-loaded cubic crystal liquid embolic precursor solution, and evaluate its in vitro embolic efficiency. Phytantriol was used as cubic crystal liquid embolic material, and the optimal formulation was selected according to ternary phase diagram. Polarized light microscopy, differential scanning calorimetry, and small angle X-ray scattering (SAXS) were used to characterize the cubic crystal structure. High performance liquid chromatography and X-ray diffraction analysis were used to investigate the lactone ring of HCPT. In vitro dissolution was preliminary evaluated, and the simulation embolic model was constructed to evaluate the embolic efficiency of precursor solution. Meanwhile, the gelation time and adhesion force were investigated. The results showed that HCPT-loaded precursor solution for embolization had been successfully prepared with low viscosity which was injectable. The precursor solution could transform into Pn3m structure liquid crystal phase gel rapidly when contracting with excess water. The formed HPCT gel remained its lactone form as the same in precursor solution, and expressed the good ability to block the saline flow, and HCPT could keep sustained releasing drug over 30 days. The prepared drug-loaded embolic precursor solution showed a promising potential for vascular embolization and application in clinical treatment of tumor.
Antineoplastic Agents, Phytogenic ; chemistry ; Calorimetry, Differential Scanning ; Camptothecin ; analogs & derivatives ; chemistry ; Delayed-Action Preparations ; chemistry ; Fatty Alcohols ; chemistry ; Liquid Crystals ; Scattering, Small Angle ; Water ; X-Ray Diffraction

OBJECTIVETo investigate the relationship between genetic polymorphism in microRNAs (miRNAs) precursor and genetic predisposition of hepatocellular carcinoma (HCC) in Chinese population.

METHODSA case-control study including 963 HCC cases and 829 HBsAg positive controls and 852 HBsAg negative controls was conducted. hsa-mir-146a rs2910164 C→G and hsa-mir-196-a2 rs11614913 T→C were selected, where the genotypes were determined by the primer introduced restriction analysis-PCR (PIRA-PCR) assay. Odd ratios (ORs) and 95% confidence intervals (CIs) were evaluated by logistic regression analysis to investigate the relationship between onset risk of HCC and different genotypes.

RESULTSThe genotype frequencies of CC, CG and GG at rs2910164 gene locus were separately 34.5% (319/925), 48.6% (450/925) and 16.9% (156/925) in cases; 36.4% (274/753), 45.0% (339/753) and 18.6% (140/753) in HBsAg positive controls; and 36.1% (303/840), 46.0% (386/840) and 18.0% (151/840) in HBsAg negative controls. The genotype frequencies of TT, CT and CC at rs11614913 were respectively 29.7% (277/934), 48.1% (449/934) and 22.3% (208/934) in cases; 30.3% (238/785), 51.0% (400/785) and 18.7% (147/785) in HBsAg positive controls; and 28.6% (239/837), 49.8% (417/837) and 21.6% (181/837) in HBsAg negative controls. No significant relationships were observed between these two single nucleotide polymorphisms (SNPs) and onset risk of HCC after adjusting the factors as age, gender, smoking and drinking status in comparison with HBsAg positive controls: hsa-mir-146a rs2910164 (CG + GG vs CC): adjusting OR = 1.10, 95%CI: 0.90 - 1.36; hsa-mir-196-a2 rs11614913 (CC + CT vs TT): adjusting OR = 1.01, 95%CI: 0.81 - 1.25; as well as in comparison with HBsAg negative controls: hsa-mir-146a rs2910164 (CG + GG vs CC): adjusting OR = 1.06, 95%CI: 0.87 - 1.29; hsa-mir-196-a2 rs11614913 (CC + CT vs TT): adjusting OR = 0.94, 95%CI: 0.76 - 1.16. As well, no significant relationships were observed between these two SNPs and onset risk of HCC in the subgroups stratified by age, gender, smoking and drinking status.

CONCLUSIONhsa-mir-146a rs2910164 C→G and hsa-mir-196-a2 rs11614913 T→C may not play an important role in the HCC predisposition among Chinese populations.

Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; Carcinoma, Hepatocellular ; genetics ; Case-Control Studies ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Liver Neoplasms ; genetics ; Male ; MicroRNAs ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide

OBJECTIVETo identify the mutations of iduronate-2-sulfatase (IDS) gene, to reveal its mutation features, and to establish a basis for genetic counseling and prenatal gene diagnosis of Hunter syndrome.

METHODSUrine glycosaminoglycans (GAGs) assay, PCR and DNA sequencing were performed to detect mutation of IDS gene of the patient and his parents.

RESULTSThe result showed that the patient was: DS(++), HS(++), KS(-), CS(-), and that both of his parents were negative. A frame-shift deletion mutation (1062 del 16) was identified in exon 7 of the patient's IDS gene. His parents' genotypes were normal.

CONCLUSIONThe patient's mutation was not inherited by his parents but a novel one. The mutation probably altered the primary structure and tertiary structure of IDS enzyme protein remarkably and lowered the activity of IDS enzyme greatly. Therefore it is supposed to be the direct cause of the disorder.

Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child, Preschool ; Female ; Glycoproteins ; genetics ; urine ; Humans ; Male ; Mucopolysaccharidosis II ; enzymology ; genetics ; urine ; Mutation ; genetics

Hot-melt extrusion was applied to prepare mesoporous silica/ethylcellulose mini-matrix for sustained release, and fenofibrate was used as a model drug, ethylcellulose and xanthan gum were chosen as sustained-release agent and releasing moderator, respectively. This novel matrix obtained the controlled release ability by combining mesoporous silica drug delivery system and hot-melt extrusion technology. And mesoporous silica particle (SBA-15) was chosen as drug carrier to increase the dissolution rate of fenofibrate in this martix. Scanning electron microscope, transmission electron microscope, small angle X-ray powder diffraction and N2 adsorption-desorption were introduced to determine the particle morphology, particle size and pore structure of the synthesized SBA-15. The results showed that SBA-15 had a very high Brunauer-Emmett-Teller specific surface area, a narrow pore size distribution, large pore volume and a ordered two-dimensional hexagonal structure of p6mm symmetry. Differential scanning calorimetry and X-ray powder diffraction results demonstrated that fenofibrate dispersed in an amorphous state inside the pores of the mesoporous silica which contributed to the improvement in the dissolution rate. The drug release of mini-matrices was influenced by ethylcellulose viscosity grades and xanthan gum concentration, which increased with the increasing of xanthan gum concentration and decreasing of ethylcellulose viscosity. Mini-matrix containing 22% xanthan gum exhibited a good sustained release performance, and the drug release behavior followed the first-order kinetics.
Adsorption ; Calorimetry, Differential Scanning ; Cellulose ; analogs & derivatives ; Delayed-Action Preparations ; Drug Carriers ; chemistry ; Particle Size ; Porosity ; Powder Diffraction ; Powders ; Silicon Dioxide ; Solubility ; X-Ray Diffraction