OBJECTIVETo explore the clinical effect of the method by using an expanded post-auricular skin flap combined with autologous rib cartilage framework for correction of concha-type microtia.

METHODSThe operation were performed in three stages. The expander was implanted under post-auricular skin at the first stage and expanded skin flap was formed. At the second stage, the expander was taken out and the expanded skin flap was transferred with autologous rib cartilage framework and skin graft for correction of microtia. At the third stage, the reconstructed ear was revised and new concha was formed.

RESULTSFrom August 2008 to August 2011, 108 cases with 113 concha-type microtia were corrected by this method. All patients healed primarily and were followed up for 6 months to 3 years. The reconstructed ears had a good appearance and position, and were symmetric to ear on the healthy sides.

CONCLUSIONSUsing expanded post-auricular skin flap combined with autologous rib cartilage framework is a reliable method for concha-type microtia.

Adolescent ; Adult ; Cartilage ; transplantation ; Child ; Child, Preschool ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Ribs ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

A strain was separeted from the Yueqing bay using pine pollen baiting.The vegetative thallus of the separated strain is oval and unincleate.It possesses a cell wall composed of many compact layers of closely pressed scales, which can be resolved where the cell wall is disrupted.The radiating branched extensions of the thallus, the ectoplasmic net, emerges from the sagenogenetosome.Asexual reproduction is by conversion of the vegetative thallus to many biflagellate zoospores, during which tetrads of cells are formed.It was identified with Schizochytrium sp.based on the features mentioned above.

Objective To explore the clinical significance of Ezrin and β?catenin in breast cancer. Methods Immunohistochemical staining method was adopted to detect Ezrin and β?catenin protein expression level in 145 cases of breast cancer tissues,and their correlation with clinical data and prognosis of breast cancer was analyzed. Results Ezrin was expressed in 70 cases(48.3%),β?catenin was expressed in 82 cases (56.6%),and there was significantly negative correlation(r=0.267,P=0.001). The higher histologic grade of breast cancer,the higher expres?sion level of Ezrin(P=0.007),and the lower expression level of β?catenin(P<0.001). Ezrin expression level was increased significantly(P=0.027),but β?catenin expression level was reduced significantly(P=0.011)in lymph node positive breast cancer tissue. Ezrin expression was sig?nificantly correlated with shorter overall survival(P=0.004)and disease free survival(P=0.017)of breast cancer patients,but β?catenin expres?sion was significantly correlated with longer overall survival(P<0.001)and disease free survival(P=0.001)of breast cancer patients. However , Ezrin and β?catenin were not the independent risk factors of breast cancer patients as determined by multivariate Cox regression. Conclusion Ez?rin was significantly negative correlated with β?catenin in breast cancer. They play a role in the progression and poor prognosis of breast cancer , which can be used as breast cancer treatment targets.

Objective To find T2N0M0 colorectal cancer patients at high risk for relapse or metastasis.Methods From January 1993 to December 2014,339 patients with histologically confirmed stage T2N0M0 primary colorectal cancer treated by radical surgery with complete clinical follow-up data were enrolled into this study.Survival rates were calculated using Kaplan-Meier method,and survival cures were compared using the Log-rank test.Cox proportional hazards model was used to analyze the significant factors defined in univariate test.Results The 5-year and 10-year overall survival rates were 83.0％ and 68.9％,respectively.Male gender,old age,lymphovascular involverment,perineural invasion,poor differentiation and invasive micropapillary carcinoma were associated with low cancer-specific survival rates in Kaplan-Meier analysis.Multivariate analyses revealed male gender,old age,lymphovascular involverment,poor differentiation and invasive micropapillary carcinoma as significant independent factors predicting poor prognosis.Conclusions Male gender,old age,lymphovascular involvement,poor differentiation and invasive micropapillary carcinoma are risk factors predicting poor prognosis for T2N0M0 colorectal patients.

To evaluate multi-slice computer tomography (MSCT) in mediastinal lymph node metastasis of T1 and T2 non-small cell lung cancer (NSCLC). Methods:A total of 32 patients with T1 and T2 NSCLC from February 2004 to October 2012 were selected. Preoperative MSCT assessment of mediastinal lymph nodes was performed on basis of the pathological results. Results:Lymph nodes with diameters of≥10 mm were evaluated, and the sensitivity and specificity of the MSCT mediastinal lymph node me-tastases were 82.4%and 92.4%, respectively. Lymph node size, primary tumor location, and visceral pleural invasion showed statistical significance in forecasting mediastinal lymph node metastases (P<0.05). Conclusion:MSCT can be used for the effective evaluation of mediastinal lymph node metastasis, lymph node size, and position of primary tumor. and visceral pleural invasion of the tumor had a higher risk of mediastinal lymph node metastasis.

Objective Searching for natural anticariogenic agent has become a focus at home and abroad.The aim of this study was to evaluate the effect of Yili dark bee propolis on the main cariogenic bacteria . Methods ①The minimum inhibitory concentration (MIC) of Yili dark bee propolis on oral common cariogenic bacteria was detected by the liquid diffusion method.②The four different con-centrations lower than MIC were used to confect culture media with pH 7.0 and the normal culture media was used as control group .The pH and the changes of pH (ΔpH) were evaluated to detect the effect of Yili dark bee propolis on acid producing ability of tested bacteria .③The effects of propolis on extracellular polysaccharides synthesis of S.mutans and A.viscosus were evaluated by anthrone method. Results①The MIC of Yili dark bee propolis on S.mutans, S.sobrinus, S.sanguis, L.acidophilus, A.viscosus and A.naeslundii were 0.78, 0.39, 1.56, 0.39, 0.2, 0.2 mg/mL, respectively.The minimum bactericidal concentrations were 1.56, 0.78, 3.125, 0.78, 0.39 and 0.39 mg/mL.②The propolis could decrease theΔpH of tested bacteria, and the differences between propolis groups and control group were statis-tically significant (P<0.05).③The propolis could reduce the ability of S.m and A.viscosus synthtic extracellular polysaccharides at MIC, and the differences were significant (P<0.05). Conclusion Yili propolis could inhibit the growth, acid producing ability and polysac-charides synthesis of the main cariogenic bacteria to some extent, and it could be deemed as a natural anticariogenic agent.

Objective To describe the current situation of oncology nurses' mastery of cancer pain-related knowledge and explore the correlation between the mastery of knowledge and nursing activities.Methods By convenient sampling,323 oncology nurses in four hospitals were recruited in the questionnaire study.Results Among the 40 pain-related knowledge questions assessed,the mean number of correctly answered questions was (19.33±3.96),with a range of 9 to 33,the correct answer rate for entire questionnaire was between 22.5％ to 81.5％,and the pass rate of the questionnaire was 0.62 ％; the score of the questionnaire had a positive correlation with pain assessment dimension and therapeutic communication and health education dimension;the self-rated score of pain-related knowledge had a positive correlation with the four dimensions; the times of nurses participating in cancer pain control study and the times of the department's cancer pain control study had a positive correlation with pain assessment dimension.Conclusions Oncology nurses did not grasp cancer pain-related knowledge well,and showed discrepancy in mastery of knowledge and nursing activities.Nursing management can strengthen nurses training in cancer pain management or increase the times of cancer pain control study to promote the implementation of cancer pain nursing activities,and to advance the quality of cancer pain nursing.

Objective To investigate the influence of salmeterol with fluticasone on airway inflammation of patients with acute exacerbation chronic obstructive pulmonary disease (COPD).Methods 40 COPD patients in the stage of acute exacerbation were randomly divided into salmeterol with fluticasone group( A group) and controll group (B group).Bronchial alveolar lavage( BAL) was performed as usual.The concentrations of IL-8 and TNF-α in bronchial alveolar lavage fluid(BALF) were measured by ELISA.The results were compared with that of 18 healthy volunteers.Results The levels of IL-8 and TNF-a in BALF of patients in A group(10.60 ± 1.42) μg/L, (14.80 ± 2.05) μg/Land B group( 10.77 ± 1.98) μg/L, (14.70 ± 2.03) μg/L were significantly higher than that of C group (3.40 ±0.65)μg/L, (4.67 ± 1.01) μg/L( all P <0.01) ;Before treatment,the levels of IL-8 and INF-α in BALF of A group( 10.60 ± 1.42)μg/L,(14.80 ±2.05) μg/L and B group( 10.77 ± 1.98) μg/L,(14.70 ±2.03) μg/L had no significant differences (all P > 0.05) ,and the concentrations of IL-8 and TNF-a in BALF in group A (4.39 ± 0.92)μg/L,(5.84 ±1.26) μg/L were significantly lower than that in group B(9.69 ± 1.43) μg/L, (12.88 ± 2.51) μg/L after two weeks treatment ( all P < 0.01).Conclusion Salmeterol with fluticasone could inhibit airway inflammation of COPD patients in the stage of acute exacerbation.

Objective To study the feasibility and security about misoprostol combined with fentanyl and propofol applied in visualization of artificial abortion.Methods 1270 cases of pregnant women who requested termination of pregnancy and voluntarily accepted abortion were selected.In the observe group,634 cases of pregnant women received oral misoprostol about 600 mg 90 minutes before surgery.After anesthetized by fentanyl and propofol,painless artificial abortion using visual abortion instrument was carried out.In the control group,636 cases of pregnant women anesthetized by fentanyl and propofol via the venous were carried out artificial abortion.The degree of cervical relaxation,loss of blood,total dose of propofol,surgical time,recovery time,the incidence of abortion complications and so on were observed.Results In the observation group and the control group,the average dosage of propofol are( 14.15 ± 2.37) ml and (16.90 ± 4.52) ml respectively;The average time required for surgery are ( 146.1 ± 38.2) s and ( 199.7 ± 37.3 ) s respectively;the average time required for awakening are ( 6.01 ± 1.90 ) min and ( 8.81 ± 2.02 )in;In the observation group,there are 405 ( 63.9% ) cases of cervical laxity markedly,in the control group,including 145 ( 22.8% ) cases of cervical laxity markedly,there is statistical significance ( P ＜ 0.05 ) between the observation group and the control group.There are no abortion syndrome in both groups.Conclusion Misoprostol combined with fentanyl and propofol was the first choice for painless artificial abortion using ultrasound visualization.

Objective To study the expression of HIF-1α and survivin in gastric cancer,and to study their role in tumor angiogenesis,invasion and metastasis.Methods Immunohistochemieal technique was used to detect the expression of HIF-1α and survivin in 54 cases of gastric cancer.Results The expression rate of HIF-lα in gastric cancer (74.1%) was higher than that in normal gastric tissue (O),The expression of HIF-1α in gastric cancer was associated with TNM staging,invasive depth and lymph-node metastasis (P<0.05),The expression of survivin in gastric cancers was high (72.2%),and increased with invasive depth (P<0.01),clinical stages (P<0.01) and lymphatic metastasis (P<0.05).There was a positive correlation between expression of HIF-1α and Survivin (r:0.31,P<0.05).Conclusion HIF-1α and Survivin could be factors in the judgement of the degree of malignancy of gastric cancer and prediction of its prognosis.