OBJECTIVETo investigate the application of expanded distant skin flaps for the facial and cervical deformities.

METHODS96 patients with facial and cervical deformities who underwent reconstructive surgery with expanded distant skin flaps were retrospectively reviewed and followed up.

RESULTSGood results were achieved in 95 cases. Necrosis happened in the distal end of one flap. The patients were followed up for 1-8 years with good cosmetic results, such as well-matched flap texture and color.

CONCLUSIONThe expanded distant skin flap is suitable and reliable for facial and cervical deformities.

Adolescent ; Adult ; Child ; Child, Preschool ; Face ; abnormalities ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neck ; abnormalities ; surgery ; Retrospective Studies ; Skin Transplantation ; methods ; Surgical Flaps ; Young Adult

Microglia are the principal immune effectors in brain and participate in a series ofneurodegenerative diseases. The microglial shapes are highly plastic. The morphology is closely related with their activation status and biological functions. Cerebral ischemia could induce microglial activation, and microglial activation is subjected to precise regulation. Microglia could play either protective or neurotoxic roles in cerebral ischemia. Therefore, regulating the expression of receptors or protein molecules on microglia, inhibiting the excessive activation of microglia and production of pro-inflammatory factors, promoting the release of neuroprotective substances might be beneficial to the treatment of cerebral ischemia. The study about relationship between microglia and cerebral ischemia will shed a light on the treatment of cerebral ischemia. This paper is a review of microglial activation and regulation during cerebral ischemia as well as related therapeutic methods.

Sphingolipids, especially ceramide and S1P, are structural components of biological membranes and bioactive molecules which participate in diverse cellular activities such as cell division, differentiation, gene expression and apoptosis. Emerging evidence demonstrates the role of sphingolipids in hepatocellular death, which contributes to the progression of several liver diseases including ischaemia-reperfusion liver injury, steatohepatitis or hepatocarcinogenesis. Furthermore, some data indicate that the accumulation of some sphingolipids contributes to the hepatic dysfunctions. Hence, understanding of sphingolipid may open up a novel therapeutic avenue to liver diseases. This review focuses on the progress in the sphingolipid metabolic pathway with a focus on hepatic diseases and drugs targeting the sphingolipid pathway.

OBJECTIVETo investigate the surgical techniques and therapeutic effect of eyelid divided nevus.

METHODSFrom January 2000 to January 2014, 27 cases with 27 eyelid divided nevi were treated by staged excision (2 cases), or full-thickness skin graft (20 cases) or frontal and facial expanded flaps (3 cases), or combined expanded flaps with skin grafts (2 cases) for large lesions. One case with skin graft underwent secondary treatment with expanded flap due to obvious scar.

RESULTSExcept for one case with residue lesion (0. 5 cm x 0. 5 cm), all the other cases underwent successful treatment with primary healing. All the patients were followed up for 3-48 months (average, 7. 4 months). Except for one case with secondary expanded flap treatment, all the other patients were satisfied with aesthetic and functional results. No occurrence happened.

CONCLUSIONSStaged excision and full-thickness skin grafts are simple and effective method for eyelid divided nevus. For large lesions, expanded flap, or combined with skin graft should be considered.

Cicatrix ; surgery ; Esthetics ; Eyelid Neoplasms ; pathology ; surgery ; Humans ; Nevus ; pathology ; surgery ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; Wound Healing

Objective To compare the clinical effect and safety of peroral endoscopic myotomy (POEM) with surgical therapy in treatment of esophageal achalasia. Methods 78 patients diagnosed as esophageal achalasia from January 2012 to October 2014 were enrolled in the study and divided into POME group and Heller group. There were 42 patients in POEM group and 36 patients in Heller group. The clinical symptom remission rate, LES resting pressure, Eckardt scores, complication rate, length of hospital stay and the hospitalization expenses were analyzed between the two groups. Results The patients in POEM group and Heller group both got clinical remissions after the treatment. There was no statistical difference in the rate of complication occurrence, Eckardt scores and LES resting pressure between the two groups. Patients in POEM group had shorter operation time, hospital stay and less expenses compared with the Heller group. Conclusions Compared with Heller group, the POEM group has the similar curative effect in treatment of esophageal achalasia. The POEM as a minimally invasive surgery has the advantages of less pain and trauma, shorter hospital stay, well tolerated and low cost. Therefore, the POEM is worth to be popularized and applied in treating esophageal achalasia.

Objective: To explore the skin condition and histological changes after face lift based on extended subcutaneous and sub-SMAS undermining and multiple accurate plication of SMAS system. Methods: Eighteen patients that underwent face lift were enrolled according to the inclusion and exclusion criterion. Objective, subjective and histological evaluations were performed to study the skin changes. Results: Nine patients completed the study and skin condition improved significantly after face lift from the objective and subjective results. Histological evaluation revealed that epidermal thickness increased along with dermal collagen content. Collagen and elastic fibers were more condensed after surgery than before, suggesting the dermal regeneration after face lift. Conclusions Skin regeneration after face lift can help maintain the postoperative result. Extensive subcutaneous dissection along with removal of lax skin as much as possible are the key points of face lift.

Objective To explore the effects of application of probiotics on intestinal flora and related cytokines in infants with cholestatic liver disease.Methods (1) Eighty-four infants with cholestatic liver disease had been hospitalized from October 2010 to June 2011 in the First Hospital of Guangxi Medical University.The infants with cholestatic liver disease were randomly divided into the probiotic intervention group and the non-probiotic intervention group.Quantification of intestinal bacteria was detected by SYBR Green Ⅰ real-time fluorescent quantitative polymerase chain reaction,then the number of 3 kinds of bacteria before and after the treatment was compared.(2) The indices of liver function,blood ammonia,cholesterol were detected.The levels of serum transforming growth factor-β1,tumor necrosis factor-α(TNF-α)and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay.Results (1) The number of bifidobacterium,lactobacillus and bifidobacterium/escherichia coli (B/E) were significantly increased (all P ＜ 0.01),whereas the number of escherichia coli was significantly decreased in the probiotic intervention group(P ＜ 0.05),however,there were no differences in the non-probiotic intervention group(all P ＞ 0.05).(2)The indices of total billirubin,direct billirubin,γ-Glutamyltransferase,total bile acid,alanine aminotransferase,blood ammonia,alkaline phosphatase were significantly improved after therapy in 2 groups (all P ＜ 0.05).The levels of TNF-α and IL-6 were significantly decreased in the probiotic intervention group (t--7.31,P =0.00;t =-2.90,P =0.01),but there were no differences in the non-probiotic intervention group.The level of BA was significantly decreased in the probiotic intervention group than the non probiotic intervention group (t =-8.37,P =0.00).(3) The B/E value were significantly inverse correlated with level of serum IL-6 (r =-0.796,P =0.01).Conclusions It may help to restore the intestinal flora and balance the immune function in infants with cholestatic liver disease after application of probiotics.

BACKGROUND: Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord.OBJECTIVE: To probe into the effect and safety of transplantation of olfactory ensheathing cells on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN: Self-control experiment.SETTING: Wards of the Department of Surgery, Taian Rongjun Hospital of Shandong Province.PARTICIPANTS: Totally 48 patients admitted for obsolete spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years.METHODS: ①Cell culture: Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and puri fied for 1 to 2 weeks, and finally made into single cell suspension. ②Operation and cell transplantation: Under general anesthesia, the purified single cell suspension (about 0.05-0.20 mL) of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 mm in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function: Injury Scoring Standard made by American Spinal Injury Association (ASIA) was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or followed up through telephone at postoperative 3 weeks to 1 year.MAIN OUTCOME MEASURES: Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients.RESULTS: ①All the 48 patients had improvement in spinal function, and continued improved tendency was found in the observation and follow-up through telephone at postoperative 3 weeks to 1 year. ②Scoring by ASIA for sensory function was higher after operation than before operation (touch sensation: 56.9, 51.2, P ＜ 0.01; pain sensation: 55.2, 48.3, P ＜ 0.01). Sensory function was improved obviously at the lower shift of sensory level,generally more than 2 segments. ③Scoring by ASIA for motor function was higher after operation than before operation (44.8, 40.7, P ＜ 0.01), but the improvement was slow. ④Scoring by ASIA for automatic nervous system was higher after operation than before operation (18.0, 14.5, P ＜ 0.01); diaphoresis, increased enterokinesia and other automatic nervous system improved earliest.CONCLUSION: Transplantation of olfactory ensheathing cells promotes the spinal and neurofunctional recovery of patients with malignant spinal injury, and the therapeutic method is safe.

Objective To investigate the role of real-time PCR(qPCR) assay for EBNA fragments in quantitative detection of Epstein-Barr virus(EBV)DNA loads and the diagnose value of combining EBNA assay with common qPCR assay (designed on Bamh1-W fragments) in Nasopharyngeal Carcinoma (NPC) patients Methods EBV DNA loads of 234 blood samples(66 NPC samples included)were detected using two methods and DNA loads inside and outside cells were detected respectively. Positive rate obtained through different methods was compared. Regression analysis and t test were used to validate the methodology. Results Positive rate of EB-NA assay(53.42% in all samples and 51.52% in NPC samples)was lower than that of Bamh1-W assay(69.23%in all samples ,71.21% in NPC samples),however the combination of two methods could enhance the positive rate(70.94% in all samples,72.73% in NPC samples),especially in NPC samples. The correlation R2 of EBNA assay and Bamh1-W assay was 0.577(P < 0.05)and the difference was statistically significant. In NPC samples , R2 was 0.828 (P > 0.05) and it showed good correlation but the difference was not statistically significant. Conclusions The combination of EBNA assay and Bamh1-W assay can improve the positive rate in EBV DNA loads detection and its efficiency is more significant in NPC patients ,which shows significance in EBV DNA loads quantification and in the auxiliary diagnosis of NPC.

Objective To compare the effectiveness and safety of two different treatment methods for patients with polycystic liver disease using super selective hepatic arterial embolization. Methods This retrospective study enrolled 41 patients with polycystic liver disease treated from June 2008 to June 2016 in the First Medical Center of Chinese PLA General Hospital. The patients underwent transcatheter super-selective hepatic arterial embdization (TAE). There were 5 men and 36 women. The age ranged from 36 to 68 years. The patients were divided into the observation group (n=14) and the control group ( n=27). The observation group underwent treatment using an emulsion of iodized oil and bleomycin and N-butyl-2-cyanoacrylate. The control group underwent iodized oil and N-butyl-2-cyanoacrylate. The clinical symptoms, operative complications, volumes of intrahepatic cysts, hepatic parenchyma volumes of pre-TAE and post-TAE at 3, 6 months and every 6 monthly were compared. Results TAE was technically successful in all the patients. The follow-up periods ranged from 24 to 72 months. The clinical symptoms improved re-markably in the observation group at 3 month, 6 months, 12 months, and 24 months, being 92. 9% (13/14), 92. 9% (13/14), 92. 9% (13/14), 92. 3% (12/13), respectively. One patient was lost to follow-up 24 months after operation. The clinical symptoms improved remarkably in the control group at 3 month, 6 months, 12 months, and 24 months, being 88. 9% ( 24/27 ), 85. 2% (23/27), 84. 6% ( 22/26 ), 81. 8% (18/22), respectively. One patient was lost to follow-up 12 months after operation and five patients were lost to follow-up 24 months after operation. Compared with preoperative, the abdominal circumference of two groups had decreased, the total volume of intrahepatic cyst and liver decreased at 6 months, 12 months, and 24 months after surgery (P＜0. 05). Conclusions TAE was a safe and effective treatment for polycystic liver disease. Patients in the observation group had more effective treatment outcomes on follow-up.