Objective To investigate the methods and effects of the double foliated anterolateral thigh flap in wound repair.Methods From March 2001 to January 2007,nine patients with adjacent soft tissue defects were treated by double foliated anterolateral thigh flap.Of all patients,three patients were with perforating injury.Results All the transplanted flaps survived,except for one patient with superficial necrosis in extremities,who got healed with dressings change and anti-infective therapy.All patients were followed up,which showed that all flaps had excellent appearance,with a normal color and consistency.Conclusion The double foliated anterolateral thigh flap has the advantages of foliated anterolateral thigh flap and is an optimal method for repairing adjacent soft tissue defects.

Objective To investigate the short-term clinical outcomes and perinatal risk factors in very low birth weight infants (VLBWI) with delayed enteral feeding (DEF).Methods Three hundred and fifty-five cases of VLBWI admitted to neonatal intensive care unit from Jan 2007 to Oct 2011 served as study objects,and the clinical data of which were analysed retrospectively.According to days to initiate enteral feeding after birth,355 VLBWI were divided into two groups:DEF group (initiate enteral feeds ≥5 days,n =55)and early feeding group (initiate enteral feeds ≤4 days,n =298).The short-term clinical outcomes were compared in 299 cases,including DEF group 44 cases and early feeding group 255 cases,in which cure or improvement were achieved and hospital stay ＞ 14 d.The perinatal risk factors were subjected to univariate and multivariate logistic regression analysis.Results The incidence of DEF was 16.05％ (57/355) in VLBWI.The time to regain birth weight in DEF group was significantly longer than early feeding group [(11.86 ± 3.86) d vs (9.76 ± 3.83) d,P ＜ 0.01],and the incidences of parenteral nutrition associated cholestasis [27.27％ (12/44)] and extrauterine growth retardation at discharge [79.55 ％ (35/44)] in DEF group were also significantly higher than early feeding group respectively [11.76％ (30/255) and 61.57％ (157/255),P ＜ 0.05].Multivariable logistic regression analysis showed that infants born to mother with placental abruption had higher risk of exposure for DEF than those without placental abruption (OR =2.74,95％ CI 1.06 ～7.05,P ＜ 0.05).Similarly,infants with mechanical ventilation had also higher odds of DEF than those with-out mechanical ventilation (OR =3.51,95 ％ CI 1.92 ～ 6.42,P ＜ 0.01).Conclusion Placental abruption and mechanical ventilation are independent risk factors for DEF in VLBWI.Improving neonatal outcome through enhancing obstetric quality and strengthening cooperation between obstetric and neonatology department is still the key to reduce DEF in VLBWI.

Objective To investigate the effects of environmental intervention on growth hormone (GH) and insulin-like growth factor 1(IGF-1) in very low birth weight infants in NICU.Methods 60 cases of very low birth weight infants were randomly divided into the experimental group and control group (30 cases in each group) in NICU from June 2012 to June 2013.By adjusting the light,reducing the noise,focusing the nursing time,the levels of growth hormone and insulin-like growth factor-1 were detected and the growth indexes were measured including body weight,length,and head circumference on the 7th day and 14th day.Results The indicators of growth and development in the experimental group on the 7th day and 14th day after birth were significantly better than those of the control group.The IGF-1 level in the experimental group on the 7th day was significantly higher than that of the control group.The GH and IGF-1 level in the experimental group was significantly higher than that of the control group.Conclusions Effective environmental intervention in NICU can improve the GH and IGF-1 lev-el of very low birth weight infants and improve their quality of life.

Objective To investigate the clinicopathologic features of the brain tissue from multilobar resection or hemispherectomy for refractory epilepsy. Methods The clinical and pathologic findings of 46 cases seen at Xuanwu hospital from 2005 to 2009 were reviewed retrospectively. Results The mean age of seizure onset and disease duration were 3.9 years and 10.2 years, respectively. There were 33 cases of hemispherectomy and 13 cases of multilobar resection. Temporal lobe abnormality was seen in all cases. The pathologic subgroups were as follows: ulegyria (31/46), malformation of cortical development (MCD, 7/46 ) and infection (8/46). Microscopic examination of ulegyria showed cortical architectural disturbances, neuronal loss, reactive gliosis and appearance of corpora amylacea. We also noted deposition of hemosiderin (13 cases), calcification (9 cases) and island-like neurons (5 cases). All ulegyria cases were accompanied by varying degree of cortical dysplasia, and hippocampus sclerosis were identified in 7 cases. MCD comprised of 5 cases of focal cortical dysplasia ( FCD), including 3 cases of FCDⅠB, 1 case of FCDⅡA and 1 case of FCDⅠA, 1 case of polymicrogyria and 1 case of porencephaly. Among 8 infection eases, there were 5 cases of Rasmussen encephalitis ( RE), l case of cysticercosis, 1 case of tuberculous meningitis and l case of Cytomegalovirus encephalitis. Conclusions The most common pathological category of specimens from hemispherectomy or multilobar resection is ulegyria with obvious temporal lobe abnormality. This is followed by MCD ( with FCDⅠB as the main type) and central nervous system infection (RE as the most frequent abnormality).

Objective To evaluate nutritional status during hospitalization of very low birth weight infant (VLBWI) and to analyze the risk factors for extrauterine growth retardation (EUGR) at discharge.Methods VLBWIs in neonatal intensive care unit (NICU),＜12 hours after birth on admission and length of hospital stay over 14 days from January 10,2007 to October 1,2011,were retrospectively studied.Relevant information,including perinatal data,weekly nutrition supplements and weight gain,and neonatal complications were collected.Data were analyzed by Chi-square test,t-test and multivariate Logistic regression analysis.Results In all 256 VLBWIs recruited,61 (23.8％) were small for gestational age at birth.One hundred and seventy-two cases,who were EUGR by weight at discharge,were divided into EUGR group.While the other 84cases were divided into non-EUGR group.The mean gestational age and mean birth weight of EUGR infants were (29.3± 1.2) weeks and (1 240± 170) g,among them,53.5％ (92/172) were extreme EUGR.Univariate analysis showed that the total energy intake [(84.9±20.9) kcal/(kg · d)],protein intake [(2.6±0.5) g/(kg · d)] and proportion ofenteral nutrition [(26.1 ± 15.3) ％] on day 7 of EUGR infants were lower than those ofnon-EUGR ones [(92.4±20.2) kcal/(kg · d),(2.8±0.5) g/(kg · d) and (30.2± 13.2) ％,respectively,t=-2.71,P=0.007; t=-2.19,P=0.030; t=-2.10,P=0.037].The enteral nutrition at the time to regain birth weight in EUGR group was lower than those in non-EUGR group [(36.4±21.6) kcal/(kg · d)vs (44.2±24.1) kcal/(kg · d),t=-2.58,P=0.011],the average growth rate after regaining birth weight and enteral nutrition proportion on day 14 were lower [(15.5±4.1) g/(kg · d) vs (17.3±3.3) g/(kg · d),(44.6± 16.6) ％ vs (49.5± 14.4) ％,respectively; t=-3.61,P=0.000; t=-2.42,P=0.016].The duration of parenteral nutrition in EUGR infants was longer than that in the non-EUGR infants [(39.6± 13.8) d vs (34.1 ±8.6) d,t=3.94,P=0.000].Multivariable logistic regression showed that small for gestational age at birth,low protein intake and low enteral nutrition proportion on day 7,low rate of weight gain after regaining birth weight were associated with EUGR on discharge,and small for gestational age at birth was the leading risk factor (OR=42.66,95％CI:9.09-200.23).Conclusions The incidence of EUGR among VLBWIs is high on discharge.Enhancing perinatal health care and early rational nutrition support are critical to reduce the incidence of EUGR and improve the neuro-developmental prognosis of these babies.

The curcumin prodrugs, which could be selectively activated in tumor cells, were prepared to establish a basis for the targeted chemotherapy for cancer. On the basis of the molecular structure of curcumin, the N-maleoyl-L-valine-curcumin (NVC), N-maleoyl- glycine-curcumin (NGC) were chemically synthesized and identified by IR and NMR spectroscopy. After treatment with these two prodrugs for 6 - 24 h, the rates of growth inhibition on human bladder cancer EJ cells and renal tubular epithelial (HKC) cells were detected by MTT colorimetry. Our results showed that after the treatment with 20 micromol/L - 40 micromol/L NVC and NGC for 6 - 24 h, the growth inhibitory effects on EJ cells were 6.71% - 65.13% (P < 0.05), 10.96% - 73.01% (P < 0.05), respectively, in both dose- and time-dependent manners. When compared with the curcumin of same concentrations, the growth inhibitory effects of these two prodrugs on HKC cells were significantly decreased (P < 0.01). It is concluded that activation of curcumin prodrugs via hydrolysis functions of cellular esterase could inhibit the growth activities of tumor cells, and reduce the side effects on normal diploid cells. This provided a novel strategy for further exploration of tumor-targeted chemotherapeutic drugs.
Antineoplastic Agents, Phytogenic/*pharmacology ; Curcumin/*pharmacology ; Dose-Response Relationship, Drug ; Prodrugs/*chemical synthesis ; Prodrugs/*pharmacology ; Tumor Cells, Cultured ; Urinary Bladder Neoplasms/*pathology

Objective To study multimodal analgesia in patients who underwent transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods 60 patients who underwent TACE for HCC from Aug.2016 to Nov.2016 were randomized into two groups:the multimodal analgesia group and the control group.The pain scores of these two groups of patient during the procedure and at different posttreatment time points,and the rates of adverse effect and pharmacoeconomic differences were recorded.Results When compared to the control group,the pain scores at 0 h,2 h,4 h,6 h,12 h after treatment in the multimodal analgesia group were significantly lower (P ＜ 0.05),and the satisfactory scores for the patients were significantly improved (96.6％ vs.66.7％).The multimodal group of patients also had significandy lower adverse effect rates of nausea and vomiting,and it was more cost-effective.Conclusions Patients who required multimodal analgesia had better pain relieve,patient satisfaction and less adverse reactions after TACE than patients in the control group.Multimodal analgesia was a safe,effective and economic way to control TACE pain and it was worth recommended in clinical practice.

The curcumin prodrugs, which could be selectively activated in tumor cells, were prepared to establish a basis for the targeted chemotherapy for cancer. On the basis of the molecular structure of curcumin, the N-maleoyl-L-valine-curcumin (NVC), N-maleoyl- glycine-curcumin (NGC) were chemically synthesized and identified by IR and NMR spectroscopy. After treatment with these two prodrugs for 6-24 h, the rates of growth inhibition on human bladder cancer EJ cells and renal tubular epithelial (HKC) cells were detected by MTT colorimetry. Our results showed that after the treatment with 20 μmol/L- 40 μmol/L NVC and NGC for 6 - 24 h, the growth inhibitory effects on EJ cells were 6.71% -65.13 % (P＜0.05), 10.96 % -73.01% (P ＜0.05), respectively, in both dose- and time-dependent manners. When compared with the curcumin of same concentrations, the growth inhibitory effects of these two prodrugs on HKC cells were significantly decreased (P＜0.01). It is concluded that activation of curcumin prodrugs via hydrolysis functions of cellular esterase could inhibit the growth activities of tumor cells, and reduce the side effects on normal diploid cells. This provided a novel strategy for further exploration of tumortargeted chemotherapeutic drugs.

Objective:To accurately and effectively identify the most critical needs of extracorporeal membrane oxygenation (ECMO) treatment for patients with severe cardiopulmonary diseases, and to better carry out continuous improvement of medical service quality an patients' satisfaction.Methods:Patients who underwent ECMO and transferred from 56 medical institutions in the Henan Provincial People's Hospital Critical Care Medicine Specialist Alliance [the patients who were transported before applying quality function deployment (QFD) from June 2017 to May 2018 were enrolled as the control group, and patients who were transported after applying QFD from June 2018 to May 2019 were the observation group], medical staff in the alliance hospitals, ECMO transfer teams and transfer driver teams were enrolled as the subjects of the survey. QFD was applied to convert the collected requirements into quality improvement elements for targeted improvement measures.Results:A total of 125 questionnaires were distributed in this survey, and 116 valid questionnaires were collected, including 91 from patients (including 27 from the control group and 64 from the observation group), 10 from the medical staff of the alliance hospitals, 10 from the ECMO transport teams and 5 from the transport driver teams. The questionnaire recovery rate was 92.8%. The improvement elements of ECMO treatment for patients with critical cardiopulmonary diseases were ranked according to the importance, and the top five were as follows: the accuracy of the first diagnosis, the specialization of ECMO team, the guarantee of vehicle safety, the seamless responses, and the smooth coordinated rescue protocol.Conclusion:The top five improvement elements should be prioritized in ECMO treatment of patients with critical cardiopulmonary disease in all hospitals of the Alliance to ensure more accurate and timely treatment.

OBJECTIVE: To explore the feasibility of radical resection for cancer patients complicated with coronavirus disease 2019 (COVID-19). METHODS: The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed. RESULTS: The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice. CONCLUSIONS The case indicates that radical resection can be performed in SARS-CoV-2 patients with twice-negative SARS-CoV-2 nucleic acid testing results.
Betacoronavirus ; isolation & purification ; Colonic Neoplasms ; complications ; surgery ; Coronavirus Infections ; complications ; therapy ; Disease Management ; Humans ; Pandemics ; Pneumonia, Viral ; complications ; therapy ; Treatment Outcome