UNLABELLEDOBJECTIVE To investigate an operative method of combined resection of preseptal fat: and partial retro-orbicularis oculus fat (ROOF) for correction of upper eyelid heaviness, and evaluate the efficacy and safety of the method.

METHODSPreseptal fat lies widely under the orbicularis oculi in the upper eyelid, and retro-orbicularis oculus fat (ROOF) lies in the lateral supraorbital area. Combined resection of preseptal fat and partial ROOF was performed in patients selected by examination. The efficacy and safety were evaluated by follow-up study.

RESULTSFrom May 2011 to July 2013, 38 selected patients received the treatment with 3 months to 28 months follow up. The heaviness of upper eyelid improved in all cases. One patient developed postoperative hematoma, and another patient had a transient numbness over the lateral upper brow region. 37 patients were satisfied with the result.

CONCLUSIONSCombined resection of preseptal fat and partial ROOF was effective in reducing the heaviness of upper eyelid, without major complications. The operative method should be an important adjunct for selected patients undergoing blepharoplasty.

Adipose Tissue ; surgery ; Blepharoplasty ; adverse effects ; methods ; Eyelids ; surgery ; Facial Muscles ; Follow-Up Studies ; Forehead ; Humans ; Safety

The discovery of quorum sensing (QS) system and its critical role in bacterial virulence have revealed a new way to attack pathogenic bacterium. The pathogenecity of QS deletion mutants decreases significantly. Targeting bacterial QS system is a promising therapeutic approach to control infections and anti-microbial resistance. To obtain natural QS inhibitors from marine organisms, marine fungi (69 strains) were isolated from marine mollusca, and their extracts were screened using improved QSIS2 (Quorum Sensing Inhibitor Selector 2) assay and Chromobacterium violaceum CV026. To improve the efficiency of QSIS2 screening, 2,3,5-triphenyltetrazolium chloride (TTC) staining method was used. Extract from strain QY013 was found to have QS inhibitory activity. Further experiment indicated that pyocyanin in Pseudomonas aeruginosa PAOI and violacein in C. violaceum CV026 were reduced by QY013 extract, without affecting bacterial growth. Morphological and 18S rDNA sequence analysis revealed that strain QY013 was most closely related to Penicillium species. The above results suggest that active constituents from QY013 may be used as novel antimicrobial agents against bacterial infection.
Animals ; Anti-Infective Agents ; isolation & purification ; metabolism ; pharmacology ; Bacterial Physiological Phenomena ; Fungi ; isolation & purification ; physiology ; Marine Biology ; Mollusca ; microbiology ; Penicillium ; isolation & purification ; metabolism ; Pseudomonas aeruginosa ; drug effects ; metabolism ; pathogenicity ; Quorum Sensing ; drug effects ; Virulence ; drug effects

Intralesional injection is a common method among various therapeutic choices for the treatment of Infantile Hemangiomas. This article reviews the clinical application of intralesional injections for infantile hemangiomas, discusses indications for intralesional injection treatment and evaluates the safety and efficacy of different injected drugs.

Objective: To investigate the effects of calcium supplementation during the pregnancy and early infancy stage on body mass index (BMI) and gut microbiota in the infants. Methods: A total of 1 752 healthy pregnant women and their infants (breast feeding) in two maternal and child health care hospitals of Beijing were chosen as the subjects in this study from May to October 2016. Questionnaires were used to obtain the general information and supplementation of calcium and vitamin D in mothers and their infants. The body length and weight of infants at birth and 6 months were recorded to calculate the BMI. The random number table method was used to randomly select 40 infants from each group for gut microbiota analysis (If less than 40 infants were all included in this study, 23 infants in the pregnancy and early infancy would be all treated with calcium supplements. There were 6 infants who was not added calcium during the pregnancy but added in the early infancy). Then it was compared that the effects of calcium supplementation during the pregnancy and early infancy on the BMI and gut microbiota composition of infants were determined at birth and 6 months. Results: Compared to the group with no calcium supplementation during the pregnancy ((12.76±1.23), (17.68±0.76)kg/m²), the BMI of infants at birth and 6 months in the group with calcium supplementation during the pregnancy ((13.51±0.47), (17.91±0.23)kg/m²) were significantly higher(P<0.05). In the group with maternal calcium supplementation, the BMI at 6 months ((18.63±0.52)kg/m²), BMI increment ((5.71±0.54)kg/m²) and the content of lactobacillus (21.04%±3.68%) in the only calcium supplementation subgroup in the early infancy were higher than those in only vitamin D supplementation subgroup ((17.69±0.89) kg/m², (4.17±1.01) kg/m² and 12.28%±3.86%) (P<0.05). In the group without maternal calcium supplementation, the content of lactobacillus (20.15%±4.87%) in the only calcium supplementation subgroup were also higher than those in only vitamin D supplementation subgroup (14.64%±3.71%) (P<0.05). Conclusion Appropriate calcium supplementation during the pregnancy is good for the growth and development of the fetus. Calcium supplementation in the early infancy could increase the BMI of infants, and promote the growth of intestinal lactobacillus.

Objective:To explore the effect sense of security and self-control on parent-child cohesion and externalizing problem behaviors in primary and middle school students.Methods:A total of 1 402 primary and middle school students were investigated with the problem behavior frequency scale(PBFS), family adaptability and cohesion scale(FACES-CV), security questionnaire(SQ) and brief self-control scale(BSCS). SPSS 25.0 and PROCESS v2.16 were used for statistical analysis, and common method deviation test, Pearson correlation analysis and intermediary effect analysis were used in the analysis.Results:Parent-child cohesion of primary and middle school students was positively correlated with security and self-control ( r=0.279, 0.303, both P<0.01), which was negatively correlated with externalizing problem behaviors ( r=-0.154, P<0.01). Security was positively correlated with self-control ( r=0.567, P<0.01). Security, self-control and externalizing problem behaviors were negatively correlated ( r=-0.147, -0.250, both P<0.01). The security and self-control of primary and middle school students played a partial mediating role between parent-child cohesion and externalizing problem behaviors.The mediating effect consisted of two paths: one was parent-child cohesion-self-control-externalizing problem behaviors, the other was parent-child cohesion-security-self-control-externalizing problem behaviors. The effect values of these two paths accounted for 20.52% and 20.26% of the total effect respectively. Conclusion:Parent-child cohesion not only directly affects the externalizing problem behaviors of primary and middle school students, but also indirectly affects the externalizing problem behavior through the independent mediating effect of self-control and the chain mediation of security-self-control.

Objective To investigate the effect of manually reverse mixing times on erythrocyte sedimenta-tion rate(ESR).Methods The ESR samples of 200 subjects were manually mixed for 3,6,9,12 and 15 times before detection.The ESR results of each group were collected,and the samples were manually mixed for 12 times as the reference standard.R(4.2.1)software was used for data analysis,Shapiro-Wilk was used for normal distribution test,Friedman test was used for multi-group comparison,and Spearman correlation analy-sis was used to analyze the correlation between different manually reverse mixing times and ESR.Results Be-fore specimen analysis,200 subjects were divided into 5 groups according to the manually reverse mixing for 3,6,9,12 and 15 times.The median ESR of each group was 13.0,11.5,11.0,8.0 and 11.0 mm/h in turn.Friedman test showed that there were significant differences in ESR results among the 5 groups(P＜0.05).There were significant differences in ESR results between manually reverse mixing for 3 and 6 times and man-ually reverse mixing for 12 times(P＜0.05).Spearman correlation analysis showed that there was a negative correlation between the manually reverse mixing times and ESR(r=-1.000,P=0.017).Conclusion Speci-mens can be fully mixed by manually reverse mixing for 9 times.Too few times of manually reverse mixing can lead to high ESR.Clinical laboratories should pay attention to the pre-treatment of specimens to ensure the quality of the whole test process.

Objective:To explore the cognition of community health care workers and the elderly on frailty, and attitudes towards frailty management.Methods:The semi-structured interview was conducted with 14 community health care workers and 17 community elderly in 3 communities in Beijing with the method of phenomenological research. We interviewed respondents' cognition on frailty management and attitudes towards frailty management. Colaizzi 7-step method was used for data analysis.Results:Three themes of cognition on elderly frailty were extracted including that the elderly in the community had different cognition and understandings of elderly frailty; community health care workers had a comprehensive understanding of the concept of elderly frailty, but not much contact with this concept; there were several misunderstandings about the cognition of elderly frailty. Four themes of attitudes towards frailty management were extracted including that the elderly want scientific frailty management; the elderly in the early stage of frailty did not agree with frailty management; community health care workers affirmed the importance of frail management; there were many obstacles to the frailty management in Beijing communities.Conclusions:It is necessary to strengthen education and publicity for the elderly frailty, speed up the formulation of evidence-based frailty management plans, guide community practice, and improve the quality of life of the elderly.

Objective:To analyze clinical features, short-term efficacy and side effects of salvage re-irradiation therapy for patients with locally recurrent esophageal cancer after definitive chemoradiotherapy, to investigate the prognostic factors of re-irradiation with precise radiotherapy techniques.Methods:A retrospective analysis was performed on patients with locally recurrent esophageal squamous cell carcinoma after definitive chemoradiotherapy treated in the Fourth Hospital of Hebei Medical University from January 2008 to December 2016. The patients underwent re-irradiation therapy (re-RT) or re-irradiation therapy concurrent chemotherapy (re-CCRT). The main observation index was after-recurrence survival (ARS), which was calculated by Kaplan-Meier method for survival analysis. Univariate analysis was conducted by log-rank test, and multivariate analysis was performed by Cox regression model.Results:A total of 109 patients were included, with a median age of 66 years (43-89 years), and a median follow-up time of 120.8 months (79.0-176.5 months). The objective response rates (ORR) and dysphagia improvement rates (DIR) in all patients were 64.2% and 63.0%, respectively. The median ARS and 1-, 3-, 5-, 8-year survival rates in all patients were 7.8 months and 32.1%, 9.2%, 7.3% and 2.3%, respectively. The median ARS and 1-, 3-, 5-years survival rates were 10.8 months and 45.9%, 13.5%, 10.8% for patients with time to recurrence (TTR) ≥24 months, significantly longer than those of 5.7 months and 25.0%, 6.9%, 5.6% for patients with TTR<24 months ( χ2=7.99, P=0.005). The median ARS in groups with re-irradiation dose of ≤50 Gy,>50-54 Gy, and>54 Gy groups were 5.7, 10.0 and 8.1 months, respectively ( χ2=6.94, P=0.031). The 1-, 3- and 5-year survival rates were 30.4%, 5.1%, and 3.8% for re-RT versus 36.7%, 20.0%, and 16.7% for re-CCRT ( χ2=2.12, P=0.145). Multivariate analysis showed that TTR ( HR=0.607, 95% CI=0.372-0.991, P=0.046) and lesion length ( HR=0.603, 95% CI=0.371-0.982, P=0.042) were the independent factors for ARS. There was no significant difference in ≥2 grade pneumonitis and 2-3 grade radiation esophagitis between the re-RT and re-CCRT groups ( χ2=0.25, P=0.619; χ2=0.51, P=0.808). The morbidity of ≥2 grade myelosuppression in the re-RT group was significantly lower than that in the re-CCRT group (3.7% vs. 36.7%, χ2=18.15, P<0.001). Conclusions:Precise re-irradiation therapy for patients with locally recurrent esophageal cancer after definitive chemoradiotherapy can alleviate dysphagia, but ARS remains poor. Re-irradiation dose range from>50-54 Gy may be suitable for locally relapse patients as salvage treatment. Patients with TTR≥24 months and lesion length ≤5 cm obtain favorable prognosis.

Objective To investigate an operative method of autologous fat transfer to retro-orbicularis oculi fat (ROOF) through upper blepharoplasty incision for correction of superior sulcus deformity and dermatochalasis,and to evaluate the efficacy and safety of the method.Methods ROOF lies in the lateral supraorbital area.Autologous fat transfer to ROOF through upper blepharoplasty incision was performed in patients selected by examination.The efficacy and safety were evaluated by follow-up study.Results From March 2013 to June 2017,23 selected patients received the treatment with 3 months to 50 months (mean,20.4 months) follow-up.The amount of fat graft for each palpebra was 0.6 to 2.0 ml,and the mean graft amount was 1.4 ml.The superior sulcus deformity improved significantly in 22 (95.7％) cases.All 23 cases achieved significant improvement of dermatochalasis.22 (95.7％) cases were satisfied with the result.No major complications occurred.Conclusions Autologous fat transfer to ROOF through upper blepharoplasty incision is effective and safe in correction of superior sulcus deformity and dermatochalasis,The operative method should be a good choice for selected patients.

Objective:To study the correlation between echogenic foci pattern of papillary thyroid carcinoma(PTC) solitary nodule and lateral cervical lymph node metastasis.Methods:The clinical data of 475 patients with echogenic foci in preoperative ultrasound and pathologically confirmed PTC solitary nodule from January to December 2014 in Fudan University Shanghai Cancer Center were retrospectively analyzed, which was categorized into lateral cervical lymph node metastasis group and lateral cervical lymph node non-metastasis group. Echogenic foci was classified into five types: local punctate echogenic foci, diffused punctate echogenic foci, coarse echogenic foci, mixed echogenic foci, peripheral annular and eggshell echogenic foci. The related clinical characteristics and the ultrasonic features were also involved. Chi-Square test and Logistic regression analysis were performed to analyze the correlation.Results:Age, preoperative human thyroglobulin (HTG) level, maximum diameter, location and echogenic foci pattern distributed to lateral cervical lymph node metastasis of PTC solitary nodule in 475 cases, according to univariate analysis ( P<0.05). Multivariate Logistic regression analysis showed diffused punctate echogenic foci, age≤35 years old, maximum diameter >10 mm and upper part were risk factors of lateral cervical lymph node metastasis of PTC solitary nodule. Conclusions:Diffused punctate echogenic foci in PTC solitary nodule, patients younger than 35 years old, maximum diameter larger than 1 cm and nodule location at upper part of the thyroid promote to lateral cervical lymph node metastasis.