This paper summarized perioperative nursing care of three patients undergoing surgical tumor resection and anterolateral femoral skin flap repair,with tumors involving intra-and extra-cranial regions from scalp squamous cell carcinoma breaking through the skull directly into the brain. Three surgical procedures were successfully per-formed by cooperation between two surgical departments and the average duration was 7 hours. The effective preop-erative infection control,perfect surgical plan,intraoperative team collaboration,effective aseptic technique and tumor-free technique were key points for the success of the operations. Close postoperative observation and positive psy-chological nursing also guaranteed operation success.

Objective To compare the perinipple round-block technique with the conventional periareolar round-block technique in areolar reduction operations.Methods A total of 37 patients who underwent areolar reduction operations in our department were randomly allocated into two groups:Group A (19 patients) received a conventional periareolar round-block technique,while group B (18 patients) through a new perinipple round-block technique.In the latter approach,an intraareolar donut of pigmented skin was deepithelialized,and the exposed areolar dermis was then telescoped inward and stretch-anchored to an imaginary circular line situated beneath the breast skin areola junction.The roundblock technique was then utilized to approximate the skin edges,resulting in a minimal scar,totally inconspicuous,confined to the immediate perinipple area.The operative time,perioperative complications,scars,absorption time of the skin folds,the sensation of the nipple-areolar complex and the patients' satisfaction were compared between the two groups.Results The mean operative time of group A and group B was 40.5 min and 45.8 min,respectively (P＜0.05).No perioperative complications were found in these two groups.No patient had experienced permanent nipple sensory changes.The skin folds absorption time of group A was 4.34 months,while the time of group B was 8.78 months (P＜0.01).The perinipple round-block technique produced a more inconspicuous scar with a better aesthetic results.Conclusions The traditional periareolar round-block technique leaves a sharply demarcated areola by a circular scar which has a totally unnatural and artificial look.As for the perinipple round-block technique,the incision as well as any residual cutaneous wrinkling or puckering is well concealed by the dome of the nipple and the areolar,but it needs a longer skin folds absorption time.

Objective To analyze the variations of glycerol-3-phosphate dehydrogenase 1 like gene (GPD1-L) and address the association with sudden m anhood death syndrom e (SMDS). Methods The genom ic DNA was extracted from blood sam ples of the SMDS group and the norm alcontrolgroup.The exons, exon-in-tron boundaries and 3′-U TRs of coding region of GPD1-L w ere PCRam plified and DNAsequenced di-rectly to confirm the types of variations. The genotype frequency and allele frequency w ere analyzed statistically. Results There w ere tw ovariants in the SMDS group, c.465C>Tand c.*18G>T, the latter existed certain degree difference of genotype distribution and allele frequency betw een the SMDS group and the control group, but there was no statistically significant (P>0.05). Conclusion The relation be-tw een gene m utation of GPD1-L and the occurrence of Chinese SMDS deserves a further research.

Using the polymmerse chain reaction (PCR), we amplified the phytase gene phyA from Pichia pastoris GS115-phyA in Aspergillus niger NRRL3135 without the signal peptide sequence and intron sequence,. Then, it was cloned into pINA1297 vector to generate a recombinant vector of pINA1297-phyA. pINA1297-phyA was linearized and transformed into Yarrowia lipolytica po1h by the lithium acetate method. The positive transformants were obtained by YNB(casa) and PPB plates, after induced in YM medium at 28 degrees C for 6 day. The activity of the expressed phytase phyA reached 636.23 U/mL. The molecular weight of the enzyme was 130 kDa measured with SDS-PAGE analysis, whereas its molecular size reduced to 51 kDa after deglycosylation which is correspond with theoretical value. The enzymatic analysis of the recombinant phytase phyA revealed its optimal pH and temperature was 5.5 and 55 degrees C, which had high activity after incubated in pH ranged from 2.0 to 8.0 for 1 h. Moreover, its activity remained 86.08% after exposure to 90 degrees C for 10 min. It also was resistant to pepsin or trypsin treatment.
6-Phytase ; biosynthesis ; genetics ; Aspergillus niger ; genetics ; metabolism ; Pichia ; enzymology ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Yarrowia ; genetics ; metabolism

Objective To investigate whether 4-OHT could decrease the ability of invasion and metastasis by reversal of EMT in TNBC. Methods Inverted microscope was used for observing cell morphological change. Cell migration ability was measured using transwell assay. Expression of E-cadherin, Vimentin and Actin proteins were analyzed by Western blot. The distribution of E-cadherin and Vimentin were analyzed by immune- fluorescence microscopy. Relative levels of miR-200c were measured by Real-time PCR. Transient transfection was performed using Lipofectamine 2000 reagent. Animal model was established to test the migration rate of lung metastasis and metastase focals. The HE staining was performed in mice lung tissue using Immunohistochemistry to confirm the metastasis. Results 4-OHT upregulates E-cadherin expression, downregulates vimentin expression to reverse EMT in TNBC cells. 4-OHT decreases migration ability of MDA-MB-231 and MCF-7/ADR cells by transwell test to 59.4% and 43.2% ; The migration ability of cells decrease to 66.7% . 4-OHT up-regulates the expression of miR-200c in MDA-MB-231 and MCF-7/ADR cells to 280% and 450%. Inhibits expression of miR-200c, 4-OHT cannot decrease migration ability of TNBC cells. Conclusions 4-OHT could decrease the ability of invasion and metastasis, up-regulate miR-200c and reverse EMT in TNBC.

Objective To evaluate treatment outcomes in patients with Cockett syndrome complicating acute lower extremity deep vein thrombosis (DVT) either by direct stenting after taking angioplasty followed by catheter-directed thrombolysis or staged stenting after taking angioplasty and catheterdirected thrombolysis with urokinase.Methods From Jun 2015 to Jun 2017,35 Cockett syndrome patients with DVT were divided into group A (direct stenting after taking angioplasty followed by catheterdirected thrombolysis,n =15) and group B (staged stenting after taking angioplasty and catheter-directed thrombolysis with urokinase,n =20).The total urokinase dosage,the time of thrombolysis,and the score of thrombolysis rate were evaluated.After six months of follow-up,the difference between two groups of limb circumference,patency rate and PTS rate were compared.Results The technical success rate in both group was 100％.There was no fatal pulmonary embolism and massive bleeding during the perioperative period.During treatment,both groups showed significant improvement in limb swelling compared with that before operation.The differences in the total used dosages of urokinase and thrombolysis time were not statistically significant (P =0.47,P =0.51 respectively).Thrombolysis rates above grade Ⅱ in group A and group B were 93.33％ and 90％ (P =0.64),but stent placement was not satisfactory in 2 cases in group A.After six months of follow-up,there was no significant difference between two groups of limb circumference and PTS rate,but patency rate of the two groups was 85.2％ ± 2.4％ and 87.6％ ± 1.8％ respectively (P =0.02).Conclusions For the treatment of Cockett syndrome with DVT,the timing of stent implantation does not affect thrombolytic treatment process.However,the complete removal of the iliac vein thrombosis is beneficial to precise release of the stent and the stent implantation can better maintain iliac vein lumen patency.

OBJECTIVETo evaluate the clinical efficacy of a new formulation of albendazole emulsion (AbzE) in cases of liver cystic hydatidosis.

METHODSTwo regimens of AbzE (10 mg.kg(-1).d(-1) and 12.5 mg.kg(-1).d(-1)) were given to 212 patients with liver cystic hydatidosis in courses ranging from 3 months to more than one year. Assessment of drug efficacy was essentially based on imaging signs with ultrasonography as the main tool. Assessments were performed at the end of different courses and in the follow-up study of 1 - 4 years after the cessation of therapy.

RESULTSAt the end of therapeutic courses, the overall cure rate of the 212 cases was 74.5%, with a 99.1% effective rate. In the follow-up study, the cure rate was 83.1%, effective rate was 89.3%, ineffective rate was 0.6%, and recurrence rate was 10.2%. The highest cure rate was observed in cases receiving AbzE 12.5 mg.kg(-1).d(-1) for 9 months. Retreatment of recurrent cases with AbzE obtained satisfactory results.

CONCLUSIONSAbzE surpassed other currently used antihydatidosis drugs or formulations with its promising efficacy and mild side effects, and could be recommended as a drug of choice in the treatment of cystic hydatidosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Albendazole ; administration & dosage ; adverse effects ; Child ; Child, Preschool ; Echinococcosis, Hepatic ; drug therapy ; Emulsions ; Female ; Humans ; Male ; Middle Aged

Objective To investigate the application of pedicled tunica vaginalis flap cover new urethra in redo and second-stage hypospadias repair.Methods Retrospective analysis was performed in 45 redo hypospadias repair cases,aged from 1 year 3 months to 9 years 4 months (median 5 years 3month).All patients were divided into urethral dehiscence after hypospadias repair (group A) and the second stage surgery of two-stage hypospadias repair (group B) based on medical history.According to the site of dehiscence,the group A were further divided into midshaft urethral dehiscence (A1) and glans and distal urethral dehiscence with urethral opening located on midshaft (A2).After new urethra was completed,the appropriate size of the pedicledtunica vaginalis flap was transferred to cover the new urethra.Results There was no scrotal hematoma occurred in all 45 cases,and somecomplications occurred,including scrotal swelling in 1 case,high-riding testicle in 2 cases,penile clockwise torsion in 1 case,urethrocutaneous fistula in 6 cases.All the 45 cases were followed up for 1 to 4 years,with mean of 1.8 years.One more urethrocutaneous fistula occurred in group A2 and 1 more urethrocutaneous fistula with urethral stricture occurred in group B.There was no penile curvature and urethral diverticulum occurred in all cases.Conclusions Pedicled tunica vaginalis flap could be used as waterproofing layer to cover new urethra in redo hypospadias repair and presented a low incidence rate of postoperative complications.

Objective:To evaluate the effect of serum cardiac troponin I (cTnI) and B-type brain natriuretic peptide (BNP) on early prediction of myocardial damage in gastric cancer patients treated with capecitabine chemotherapy.Methods:From July 2017 to June 2018, 88 patients with advanced gastric cancer who received treatment in Liaoning Cancer Hospital & Cancer Hospital of China Medical University were selected for retrospective analysis. According to different treatment methods, they were divided into paclitaxel combined with cisplatin (PC) treatment group and PC combined with capecitabine(PCX) treatment group. Serum cTnI and BNP were used as indexes before treatment, after treatment and three months after treatment. At the same time, the changes of ECG before and after treatment were analyzed.Results:At the end of the course of treatment, the serum cTnI concentration of PCX treatment group and PC treatment group was (0.582 9 ± 0.012 4) μg/L and (0.059 8 ± 0.011 2) μg/L, respectively, with statistical significance ( P<0.05); three months after the course of treatment, the serum cTnI concentration of the two groups was (0.558 5 ± 0.015 6) μg/L and (0.051 8 ± 0.009 9) μg/L respectively, with statistical significance ( P<0.05). And at the end of the course, the serum BNP concentration of PCX treatment group and PC treatment group was (495.6 ± 35.6) ng/L and (154.3 ± 29.8) ng/L respectively, with statistical difference between the two groups ( P<0.05). Three months after chemotherapy, the serum BNP concentration of the two groups was (155.5 ± 29.6) ng/L and (139.6 ± 30.1) ng/L, with no statistical difference ( P>0.05). There was no significant difference of BNP concentration between the two groups after treatment for 3 months ( P>0.05). The average abnormal rate of ECG before treatment was 21.6% (9.5 cases on average) and after treatment was 28.4% (12.5 cases on average), there was no significant difference between the two groups ( P>0.05). Conclusions:Early detection of cTnI and BNP concentrations can predict early myocardial damage in gastric cancer patients receiving capecitabine chemotherapy, and timely adjustment of the regimen can make the clinical application of capecitabine safer and more effective.

Objective To investigate the effect of a modified preputial flap urethroplasty in twostage treatment of severe hypospadias.Methods The clinical characteristics of the severe hypospadias patients (41 cases) who underwent the staged urethroplasty by using the procedure of preset urethral plate with preputial flap from January 2015 to December 2016 were analyzed retrospectively.We used a modified method (modified group,23 cases):Form the distal urethra with the transected distal urethral plate by using tubularize incised plate (TIP) procedure during the first stage operation,after completely straightened the penis,urethral plate was preseted with transverse preputial flap at the penis shaft.While in the traditional group (18 cases),urethral plate was preseted with preputial flap by using Bracka procedure after transecting urethral plate.The corresponding missing part of urethra underwent urethroplasty at the second stage operation six months later.The patients in the modified group were 9 to 18 months old,and the median age was 13 months;meatus were located at the penis shaft in 10 cases,scrotum in 12 cases,perineum in 1 case.The patients in the traditional group were 9 to 18 months old,and the median age was 13 months;meatus were located at the penis shaft in 6 cases,scrotum in 10 cases,and perineum in 2 cases.There was no statistic difference in age and meatus position between the two groups.Results During the first stage operation,distal urethra was repaired by 13-19 mm,with an average of (14.5 ± 1.3) mm,and the proximal urethra was repaired by 0-6 mm,with an average of (3.1 ± 2.4) mm at the modified group.While at the traditional group,the length of proximal urethra was repaired of 0-9 mm,with an average of (5.6:±:2.9) mm.The urethral length required for reconstruction was measured during the second stage operation,with an average of (26.3:t:4.4) mm in the modified group and (40.5 ± 3.3) mm in the traditional group (P ＜ 0.05).There were 3 case of urethral stricture after removed the catheter,with 2 cases in the modified group and 1 case in the traditional group.Postoperative follow-up was 2 to 3 years,with an average of 2.4 years.There were 3 cases (3/23,13.0％) of urethral fistula in the modified group and 3 cases (3/18,16.7％) in the traditional group.Ascended testis occured in 2 patients in the traditional group after operation.No case of urethrostenosis,diverticulum,chordee or concealed pennis was recorded.There was no significant difference in postoperative complications between the two groups (P ＞ 0.05).Conclusions The modified staged preputial flap method shorten the new forming urethra by making full use of its own materials at the second stage operation,which was helpful to reduce complications.