Objective:To investigate the application in the preparation of supraclavicular island flap by "point line anterograde dissection (PLAD) ".Methods:A retrospective analysis was performed on 45 flaps of 43 patients treated with supraclavicular artery island flap from the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital Affiliated to Capital Medical University from January 2013 to June 2019. The patients were all male, aged 35-72 years old. There were 26 cases of hypopharyngeal cancer, 4 cases of recurrent laryngeal cancer, 2 cases of cervical esophageal cancer, 1 case of tonsillar cancer, 1 case of parotid gland cancer, 3 cases of postoperative pharyngeal fistula after hypopharyngeal cancer, 2 cases of esophageal fistula after trauma, 2 cases of esophageal stricture after hypopharyngeal carcinoma operation, 1 case of autoimmune laryngeal stenosis, and 1 case of cheek defect after maxillary sinus cancer operation."Point" was the origin of the supraclavicular artery in the transverse carotid artery. "Line" was an extension line made along the starting point of the supraclavicular vessel for anterograde anatomy of 1-2 cm and the direction of the blood vessel. The extension line was used as the central axis of the designed island flap. Characteristics of flap blood supply, the time of flap preparation, flap survival, donor area recovery and clinical follow-up were recorded.Results:The arterial blood supply of the flap was constant, and the venous reflux was variable. The area of the prepared flap was (4-8) cm×(10-18) cm, and the preparation time was 30-60 min, with a median of 42 min. Skin flap survival rate was 100%. Partial necrosis of skin flap occurred in 1 patient and postoperative pharyngeal fistula occurred in 5 patients, all of whom were cured by dressing change. The donor site defects were closed and sutured directly. 3 patients had partial incision dehiscence and healed after dressing change. During the follow-up, 1 patient was lost, and the remaining 42 patients were followed up for 8 to 55 months.40 patients involved swallowing function, all of them returned to regular diet or soft fluid after operation.40 patients involved malignant tumors and local tumor recurrence in 3 patients among whom, there were 2 cases of lymph node recurrence, and 2 cases of distant metastasis, including 1 case of lung metastasis and 1 case of bone metastasis.Conclusion:PLAD is a simple, safe and efficient method for the preparation of supraclavicular island flap.

Endoplasmic reticulum (ER) stress is mediated by disturbance of Ca²⁺ homeostasis. The store-operated calcium (SOC) channel is the primary Ca²⁺ channel in non-excitable cells, but its participation in agent-induced ER stress is not clear. In this study, the effects of tunicamycin on Ca²⁺ influx in human umbilical vein endothelial cells (HUVECs) were observed with the fluorescent probe Fluo-4 AM. The effect of tunicamycin on the expression of the unfolded protein response (UPR)-related proteins BiP and CHOP was assayed by western blotting with or without inhibition of Orai1. Tunicamycin induced endothelial dysfunction by activating ER stress. Orai1 expression and the influx of extracellular Ca²⁺ in HUVECs were both upregulated during ER stress. The SOC channel inhibitor SKF96365 reversed tunicamycin-induced endothelial cell dysfunction by inhibiting ER stress. Regulation of tunicamycin-induced ER stress by Orai1 indicates that modification of Orai1 activity may have therapeutic value for conditions with ER stress-induced endothelial dysfunction.
Blotting, Western ; Calcium ; Endoplasmic Reticulum ; Endoplasmic Reticulum Stress ; Endothelial Cells ; Homeostasis ; Human Umbilical Vein Endothelial Cells ; Tunicamycin ; Unfolded Protein Response

Objective To analyze the clinical and histopathological features,immunophenotypes,treatment and prognosis of subcutaneous panniculitis-like T cell lymphoma (SPTL).Methods Clinical and experimental data were collected from 9 cases of SPTL,and retrospectively analyzed.Related pathological and immunohistochemical markers were examined by Envision method.Eight patients were followed up.Results Of the 9 patients,8 had multiple subcutaneous nodules and plaques,which mainly involved the lower limbs in 8 patients and the trunk in 6 patients.Seven patients had fever.Three patients were subjected to the whole-body positron emission tomography-computed tomography (PET-CT),and 7 to bone marrow aspiration.No visceral tumors and hemophagocytic syndrome were found.Histopathological examination of skin lesions showed atypical mononuclear cells with large nuclei and deep staining,which mainly infiltrated the subcutaneous adipose tissue and were arranged in a circular pattern.Among 9 patients,infiltration of tumor cells was observed around skin appendages and blood vessels in the dermis in 5 patients.Immunohistochemical examination showed positive staining for βF1,CD3 and CD8 in tumor cells in 9 cases,positive staining for granzyme B and T-cell-restricted intracellular antigen-1 (TIA-1) in 8 cases,and negative staining for CD4,CD20,CD30 and CD56 in all the patients.Five patients received chemotherapy,including a child and a postpartum woman.One child received methylprednisoloue pulse therapy.During the follow-up,8 patients achieved a complete clinical remission after treatment.Conclusion SPTL is derived from α/β T cells,and histopathological and immunohistochemical examinations can be helpful for its diagnosis and differential diagnosis.

Objective To investigate the biokinetics of 131 I and its absorbed dose in patients with metastatic DTC. Methods Forty?one patients with metastatic DTC who were referred to 131 I therapy were prospectively recruited from September 2009 to September 2011. Scintigraphic images were serially acquired after the ingestion of 131I (3.70-9.25 GBq) to assess the biokinetics. CT was used to measure the masses of the DTC lesions. Calculation of absorbed doses to DTC lesions was based on the Medical Internal Radiation Dosimetry formula of the Society of Nuclear Medicine and Molecular Imaging. Kruskal?Wallis rank sum test was used to compare the differences of absorbed dose among different tumor deposits. Results In total, 59 io?dine?avid metastatic lesions (35 in cervical lymph node, 17 in lung and 7 in bone) in 41 patients were evalu?ated and the mean absorbed dose of DTC lesions was (10.4±6.5) Gy/GBq, with range of 0.1 to 136.2 Gy/GBq. The median absorbed dose was 11.3 Gy/GBq for lymph node metastase, 10.1 Gy/GBq for lung metastases and 9.6 Gy/GBq for bone metastases. There were no statistically significant differences in absorbed doses a?mong the metastases of lymph node, lung and bone ( Z=0.907, P>0.05) . Conclusion A wide inter?lesion variation of absorbed dose to metastatic DTC is observed.

Objective To discuss the feasibility and effect of the new look-up table method in the diet health management of type 2 diabetes patients. Methods 200 patients with type 2 diabetes in department of endocrinology in our hospital were divided into experimental group and control group according to the random number table method and 100 cases in each group. The new look-up table method and food exchange method were used respectively to intervene. Before the intervention and 6 months after the intervention, the clinical related metabolic indexes and diet self-management scores of patients in two groups were monitored, meanwhile, the time for nurses to guide patient to learn self-catering arrangements was calculated. Results Fasting blood glucose, postprandial 2 hours blood glucose, glycosylated hemoglobin of patients in experimental group were respectively (9.64±4.62) mmol/L, (12.37±4.88) mmol/L, (9.26 ± 2.56) % before intervention and were respectively (6.74 ± 3.87) mmol/L, (9.16 ± 4.76) mmol/L, (7.21 ± 3.21) % at 6 months after intervention, the difference was statistically significant (t=4.81, 4.71, 4.99, P < 0.01). However, fasting blood glucose, postprandial 2 hours blood glucose, glycosylated hemoglobin of patients in control group were respectively (9.14 ± 5.28) mmol/L, (12.95 ± 4.65) mmol/L, (9.12±3.31)%before intervention and were respectively (7.29±4.98) mmol/L, (10.01±5.56) mmol/L, (7.36± 2.86)%at 6 months after intervention, the difference was statistically significant (t=2.55, 4.06, 4.02, P<0.05 or 0.01). The diet self-management scores of patients were significantly improved in two groups, the scores of experimental group were (9.52±5.45) points before intervention and (13.70±7.11) points after 6 months intervention, the difference was statistically significant (t= 4.44, P < 0.01). The scores of control group were (9.18±6.32) points before intervention and (11.27±6.38) points after 6 months intervention, the difference was statistically significant (t=2.33, P<0.05). Meanwhile, the difference between two groups was statistically significant (t=2.54, P<0.05). The time needed for the education of experimental group was less than that of control group, (22.47 ± 5.84) min in experimental group and (32.23 ± 7.66) min in control group respectively, the difference was statistically significant (t=10.13, P < 0.01). Conclusions The new look-up table method is more convenient and can improve diet self-management ability for patients. It can also improve the work efficiency of clinical nurses and has the feasibility and applicability in the diet management of diabetes patients.

BACKGROUND:Vertebroplasty with bone cement injection can achieve a correction of kyphosis, enhancement of vertebral strength, and elimination of vertebral lesions during reduction of the fracture. OBJECTIVE: To analyze the efficacy of vertebroplasty with bone cement injection on osteoporotic vertebral compression fracture. METHODS:Totaly 84 patients with osteoporotic thoracolumbar vertebral compression fractures (T6-L4), 37 males and 47 females, aged 58-80 years, were randomized into two groups: study group undergoing vertebroplasty with bone cement injection and control group subject to bed rest and conservative treatment (functional exercise of the back muscle). Visual analog scale score, Oswestry disability index and vertebral height were detected and compared between the two groups before and after treatment. RESULTS AND CONCLUSION:There was no difference in vertebral height, visual analog scale score and Oswestry disability index between the two groups before treatment. At 3 months after treatment, the vertebral height was (1.653±0.168) cm in the study group and (1.521±0.200) cm in the control group, with a significant difference (P< 0.05). The visual analog scale scores and Oswestry disability index scores in the study group were both lower than those in the control group at 3 months after treatment and at the last folow-up (P < 0.05). After treatment, there were two cases of pressure sores, three cases of deep venous thrombosis, one case of pneumonia and two cases of urinary tract infections in the control group; while only 4 cases developed bone cement leakage in the study group, but with no obvious clinical symptoms. No difference in re-fracture rate occurred between the control group (n=3) and study group (n=4;P > 0.05). These findings suggest that the bone cement injection as vertebral augmentation therapy can rapidly relieve pain, improve patients' quality of life within a short term and restore the vertebral height in patients with osteoporotic vertebral compression fractures.

Objective To investigate the effect of chronotherapy (chemotherapy plus timely medication) on neutrophils in breast cancer patients with neoadjuvant chemotherapy.Methods Fifty breast cancer patients with neoadjuvant chemotherapy were selected from 2011 to 2014 and divided into chronotherapy group and conventional treatment group (conventional group) by random number table method with 25 cases each.Conventional group received conventional neoadjuvant chemotherapy and conventional drug treatment.Chronotherapy group received neoadjuvant chemotherapy combined with chronochemotherapy and timely medication treatment,and applied clinical nursing care pathway.Both groups were conducted three cycles of chemotherapy,three weeks after the first and the second chemotherapy,the results of routine blood and liver function were compared in patients between two groups.The number of readmission and fever because of agranulocytosis were calculated.Results The two groups of patients were successfully completed three cycles of chemotherapy,after the first cycle of chemotherapy,the neutrophil was (4.40 ± 2.20)x109/L in chronotherapy group,and (3.18 ± 1.35) × 109/L in conventional group;after the second cycle of chemotherapy,the neutrophil was (3.95 ± 1.58) × 109/L,and (2.83 ± 1.49) x 109/L in conventional group,the two groups were statistically significant,t=2.375,2.563,P ＜0.05.Two cases needed readmission in chronotherapy group during chemotherapy,accounting for 8％(2/25),much lower than conventional group of 8 cases accounting for 32％(8/25).Conclusions The use of chronotherapy in breast cancer chemotherapy has less neutropenia,mild side effects of bone marrow suppression.It is an effective and safe viable option.

Objective To investigate the relationship between the absorbed dose to the thyroid remnant and the outcome of m I ablation in patients after operation for DTC.Methods Seventy-two patients (14 males,58 females; age range:16-67 years,average age:(41±16) years) with DTC,prepared for thyroid remnant ablation,were prospectively recruited from September 2009 to September 2011.Scintigraphic images of the head and neck were serially acquired after oral administration of 3.7 GBq of 131I to assess the biokinetics of this tracer in thyroid remnant.Ultrasound was used to measure the mass of the thyroid remnant.Calculation of absorbed dose to thyroid remnant was based on the Medical Internal Radiation Dosimetry formula of the Society of Nuclear Medicine.The outcome of 131 I ablation was evaluated on the basis of stimulated Tg measurements and neck ultrasound at 6-9 months after ablation.Patients with stimulated Tg levels less than 1 μg/L and with no detectable thyroid tissue on neck ultrasound were considered successful ablation of thyroid remnant.Two-sample t test was used to analyze the data.Results The 131I uptake ratios at 24 h were 0.9％-6.3％ in 72 patients and the effective half-lives of 131I were 12.0-146.4 h.The thyroid remnant masses were 1.0-6.9 g; absorbed doses were 23-2 197 Gy,and absorbed dose rates at 24 h were 0.5-8.1 Gy/h.No significant difference was observed in absorbed doses to thyroid remnants in 43 patients having successful ablation and 29 patients having unsuccessful ablation ((363± 148) Gy vs (341± 167) Gy,t =15.097,P＞0.05).However,the absorbed dose-rates of thyroid remnants at 24 h were significantly higher in patients with successful ablation than those in patients with unsuccessful ablation ((3.7±2.1) Gy/h vs (2.9±1.6) Gy/h,t=7.908,P＜0.05).Conclusion A successful ablation is strongly dependent on the absorbed dose-rate of thyroid remnant.

For patients with DTC,the side effect of 131I therapy on fertility and offspring is an important issue since genital tissues are highly sensitive to radiation.Exposure to 131 I radiation may result in transient impairment of gonadal function in male patients caused by elevated levels of serum follicle stimulating hormone and luteinizing hormone,low sperm count and motility.In female patients,exposure to 131I radiation may be complicated with delay of menstruation,oligomenorrhea and transient cessation of menstrual period.Most of these symptoms may resolve within one year after 131 I therapy.A slightly earlier menopause is the only reported long-term side effect of 131I therapy on ovarian function.Currently available data do not indicate that exposure to 131I may cause permanent infertility in male patients with DTC.For female patients with DTC,131 I therapy does not affect fertility or pregnancy outcomes beyond one year.

The effects of ketamine on transient outward potassium current (I(to)) of isolated human atrial myocytes were investigated to understand the mechanism of part of its effects by whole-cell patch-clamp. Atrial myocytes were enzymatically isolated from specimens of human atrial appendage obtained from patients under going cardiac valve displacing. Ito is recorded in voltage-clamp modes using the patch-clamp technique at room temperature. Currents signals were recorded by an Axopatch 200B amplifier with the Digidata 1322A-pClamp 9.0 data acquisition system. Ketamine decreased I(to) of human atrial myocytes in a dose-dependent manner. The current-voltage curve was significantly lowered, 30, 100, 300, and 1000 micromol x L(-1) ketamine decreased respectively I(to) current density about (13.62 +/- 0.04)%, (38.92 +/- 0.05)%, (72.24 +/- 0.10)% and (83.84 +/- 0.05)% at the potential of 50 mV, with an IC50 of 121 micromol x L(-1). The I(to) activation curve, inactivation curve and the recovery curve were not altered by ketamine. So, ketamine concentration-dependently decreased I(to) of human atrial myocytes.