Objective To evaluate the value of three-dimensional scanning technology in the preoperative design of tissue expansion procedures,with the expectation of making objective and accurate judgments regarding the timing of the second-stage expanded flap transfer surgery for patients,in order to avoid insufficient or excessive expanded flap areas.Methods From April 2024 to September 2024,we treated 10 patients who planned to undergo local tissue expansion for head and neck reconstruction.We utilized the Vectra WB360 three-dimensional imaging device to measure the wound defect area,the base area of the expander,and the expanded flap area in these patients,and compared these measurements with intraoperative results to assess the accuracy of this technology in guiding tissue expansion surgery.Results In 10 cases,the surface area of the expander(expansion skin area),the base area of the expander,and the lesion area were measured using the Vectra WB360 3D imaging device,with average measurements of(539.3±268.4)cm2,(157.0±78.13)cm2,and(252.8±141.6)cm2.Intraoperative actual measurements were(470.7±230.4)cm2,(159.9±83.2)cm2,and(241.7±134.1)cm2.Statistical analysis revealed no significant differences between the device-measured base area of the expander and lesion area compared to the intraoperative actual measurements(P＞0.05).The device-measured expanded skin area was greater than the intraoperative flap area(P＜0.05),which is associated with the retraction of the expanded skin after the removal of the expander.During the opearation,the flaps were able to completely cover the wound,and all flaps survived postoperatively.Follow-up at 1 to 6 months indicated good recovery of the surgical site's appearance and function,with a high level of patient satisfaction.Conclusion The Vectra WB360 three-dimensional imaging device significantly improves the accuracy of preoperative flap area estimation,optimizes surgical planning,and thereby enhances the success rate of expanded skin flap surgery.

Objective To evaluate the value of three-dimensional scanning technology in the preoperative design of tissue expansion procedures,with the expectation of making objective and accurate judgments regarding the timing of the second-stage expanded flap transfer surgery for patients,in order to avoid insufficient or excessive expanded flap areas.Methods From April 2024 to September 2024,we treated 10 patients who planned to undergo local tissue expansion for head and neck reconstruction.We utilized the Vectra WB360 three-dimensional imaging device to measure the wound defect area,the base area of the expander,and the expanded flap area in these patients,and compared these measurements with intraoperative results to assess the accuracy of this technology in guiding tissue expansion surgery.Results In 10 cases,the surface area of the expander(expansion skin area),the base area of the expander,and the lesion area were measured using the Vectra WB360 3D imaging device,with average measurements of(539.3±268.4)cm2,(157.0±78.13)cm2,and(252.8±141.6)cm2.Intraoperative actual measurements were(470.7±230.4)cm2,(159.9±83.2)cm2,and(241.7±134.1)cm2.Statistical analysis revealed no significant differences between the device-measured base area of the expander and lesion area compared to the intraoperative actual measurements(P＞0.05).The device-measured expanded skin area was greater than the intraoperative flap area(P＜0.05),which is associated with the retraction of the expanded skin after the removal of the expander.During the opearation,the flaps were able to completely cover the wound,and all flaps survived postoperatively.Follow-up at 1 to 6 months indicated good recovery of the surgical site's appearance and function,with a high level of patient satisfaction.Conclusion The Vectra WB360 three-dimensional imaging device significantly improves the accuracy of preoperative flap area estimation,optimizes surgical planning,and thereby enhances the success rate of expanded skin flap surgery.

Microphthalmia-associated transcription (MiT) family translocation related renal cell carcinoma (RCC) is an important type of renal cell carcinoma, which was included in the new classification of renal tumors by the World Health Organization (WHO) as an independent subtype in 2016. This type of renal cell carcinoma mainly includes Xp11.2 translocation /TFE3 gene fusions associated with renal cell carcinoma and T (6; 11)(p21; q12)/TFEB gene fusion-associated renal cell carcinoma, which has similar clinical features, histology, immunohistochemistry, and molecular genetics, but is significantly different from other renal cell carcinomas. In this review, the clinicopathology and genetics of MiT family translocation associated renal cell carcinoma were reviewed in order to provide guidance and help to the clinical and pathologic work.

Objective:To investigate the effect of indocyanine green angiography (ICGA) in the design of pre-expanded perforator flaps in the reconstruction of large defects.Methods:From October 2018 to October 2019, there were 22 patients undergoing facial and cervical reconstructive surgeries based on pre-expanded perforator flaps in the back region in Shanghai Ninth Peoples′ Hospital. 12 male and 10 female patients, ranging from 4 to 26 years old with an average age of 19, were all suffered from inferior facial and cervical defects after burns. Single-pedicled or multi-pedicled perforator flaps from back region were designed for treatment. ICGA was conducted after flap dissection intra-operatively to evaluate perfusion areas of perforators, which helped surgeons to determine whether supercharging should be conducted. After flap transplantation, ICGA was conducted again to evaluate the blood supply. Statistics of post-operative complications such as flap necrosis were collected.Results:the average flap size was 27 cm ×17 cm. With the guidance of ICGA, 15 cases remained the design of single pedicle including 5 superficial cervical artery (SCA) flaps and 10 free circumflex scapular artery (CSA) perforator flaps. Supercharging was performed in 7 cases: including 2 SCA flaps supercharged with CSA perforator and 5 free CSA perforator flaps supercharged with thoracodorsal artery (TDA) perforator. Venous thrombus occurred in 1 case but recovered after re-anastomosis of vessels. Except for 2 tip necroses, 20 flaps survived completely one week postoperatively. 2 tip necroses were recovered after dressing changes. All the patients were followed up for 5 to 16 months, with good flap color and texture, and improved function of head and neck.Conclusions:ICGA can be used as a safe and effective intraoperative detection method to guide the selection of appropriate perforators and the decisions on whether to conduct supercharging, which optimizes flap design and improves the success of surgery.

Objective:To investigate the effect of indocyanine green angiography (ICGA) in the design of pre-expanded perforator flaps in the reconstruction of large defects.Methods:From October 2018 to October 2019, there were 22 patients undergoing facial and cervical reconstructive surgeries based on pre-expanded perforator flaps in the back region in Shanghai Ninth Peoples′ Hospital. 12 male and 10 female patients, ranging from 4 to 26 years old with an average age of 19, were all suffered from inferior facial and cervical defects after burns. Single-pedicled or multi-pedicled perforator flaps from back region were designed for treatment. ICGA was conducted after flap dissection intra-operatively to evaluate perfusion areas of perforators, which helped surgeons to determine whether supercharging should be conducted. After flap transplantation, ICGA was conducted again to evaluate the blood supply. Statistics of post-operative complications such as flap necrosis were collected.Results:the average flap size was 27 cm ×17 cm. With the guidance of ICGA, 15 cases remained the design of single pedicle including 5 superficial cervical artery (SCA) flaps and 10 free circumflex scapular artery (CSA) perforator flaps. Supercharging was performed in 7 cases: including 2 SCA flaps supercharged with CSA perforator and 5 free CSA perforator flaps supercharged with thoracodorsal artery (TDA) perforator. Venous thrombus occurred in 1 case but recovered after re-anastomosis of vessels. Except for 2 tip necroses, 20 flaps survived completely one week postoperatively. 2 tip necroses were recovered after dressing changes. All the patients were followed up for 5 to 16 months, with good flap color and texture, and improved function of head and neck.Conclusions:ICGA can be used as a safe and effective intraoperative detection method to guide the selection of appropriate perforators and the decisions on whether to conduct supercharging, which optimizes flap design and improves the success of surgery.

Objective: To summarize clinical experience on reconstruction of severe facial disfigurement with flap prefabrication and soft tissue expansion. Methods: From September 2005 to June 2016, 49 patients with type Ⅲ and type Ⅳ facial deformities underwent facial reconstruction with an integrated method on the basis of prefabricated flaps. In the first stage, the descending branch of the lateral femoral circumflex vessels and the surrounding muscle fascia were dissected and transferred to subcutaneous pocket in the cervicothoracic area. The pedicles of the fascial flap were anastomosed to either the facial or superior thyroid artery and their venae comitantes in flap prefabrication. A tissue expander was placed beneath the fascial flap. In the second stage, over-expansion was achieved with intra-flap stem cell transplantation once patient′s skin showed signs of intolerance to expansion. In the third stage, prefabricated flap was transferred to cover the facial defects. the second or third internal mammary artery perforators or lateral thoracic artery perforators were reserved and flap supercharging would be performed depending on the perfusion of the flap revealed by indocyanine green angiography intra-operatively. Later, flap revisions further restored facial outline and delicate organ configuration. Aesthetic and functional status were independently graded to assess the facial appearance and function before and after the reconstruction. Results: 49 patients with severe facial deformities were included. 5 patients received stem cell transplantation. The final inflated volume ranged from 2 530 ml to 3500 ml and each patient had facial reconstruction with a prefabricated flap (range 23 cm×18 cm-34 cm×32 cm). Flap supercharging technique were used in 25 cases to augment blood perfusion, however, flap necrosis (5 cm× 2 cm) occurred in 1 patient, and tip necrosis occurred in 4 patients, otherwise, all flaps survived entirely. The aesthetic (1.15 to 2.29) and functional (0.86 to 2.42) status scores were statistically improved (P<0.01). Facial expressions such as smiling, blinking and frowning were noted. Conclusions Autologous full face reconstruction with an integrated method based on flap prefabrication can bring satisfying aesthetic and functional recovery, rendering a safe and effective option for most patients with massive facial defects.

Objective To investigate the diagnostic value of cyclophilin A(CyPA)for chronic heart failure (CHF).Methods Eighty pateints,made a definite diagnosis as CHF,were classified 30 cases as A phase,29 cases as C phase,21 cases as D phase of them.30 healthy subjects were enrolled in this study.Serum CyP A was detcted by ELISA.NT-proBNP was detec-ted with Roche Cobas 6 000 automatic electrochemilu-minescence immunoassay system.Results The amounts of serum CyP A(x-±s,ng/ml)in healthy subjects and each group with CHF were 110.10±49.73,327.85±82.67,331.70±69.34 and 342.46±92.55.Using Oneway Anova,CyP A concentration of CHF was significantly higher than healthy controls (F=58.45,P<0.01).Further using Post Hoc Tests-Multiple Comparisons,the CyP A concentration of each group with CHF was significantly higher than the healthy control group (Mean differences were 217.75~232.36,P<0.01),but showed no significant difference between the groups with CHFs (Mean differences were 3.37~14.61,P>0.05).Results of ROC curves showed the AUC (CyP A)was 0.97.The best cutoff value was 198.39 (ng/ml).The sensitivity was 91.30%,the specificity was 93.30%.The correlation analysis showed that CyP A and NT-proBNP were correlated (r=0.30,P<0.01). CyP A and NT-proBNP combined detections showed the sensitivity was 93.80% and the specificity was 100%.Conclusion The Cyp A levels in CHF group are significantly higher than the control group,suggesting that Cyp A may be a factor for CHF appearance.These results indicate that combined detections may helpful to early diagnosis of CHF.

Objective To investigate the significance of Ang-Ⅱ in diagnosis of chronic heart failure.Methods Eighty patients with chronic heart failure were divided into 3 groups:A phase with 30 cases,as C phase with 29 cases and D phase with 21 cases.30 healthy subjects were enrolled in this study.Serum Ang-Ⅱ was detected by ELISA.NT-proBNP was detected with Roche Co-bas6000 automatic electrochemiluminescence immunoassay system.Results Using Oneway Anova,the Ang-Ⅱconcentration of pa-tients with chronic heart failure was significantly higher than that of the healthy subjects (F =38.35,P <0.01).Further using Post Hoc Tests-Multiple Comparisons,the Ang-Ⅱ concentration of each group with chronic heart failure was significantly higher than that of the healthy control group.Results of ROC curves showed the aera under the curve of Ang-Ⅱwas 0.92.The best cutoff value was 552.25 (ng/mL).The sensitivity was 90.00%,and the specificity was93.30%.The correlation analysis showed that Ang-Ⅱwere correlated with NT-proBNP(r=0.23,P <0.05).The sensitivity and the specificity of combined detection of Ang-Ⅱand NT-proBNP were 98.80% and 100%,respectively.Conclusion The Ang-Ⅱlevels in chronic heart failure groups are significantly high-er than that in the control group,which indicates that combined detection may be helpful to the early diagnosis of chronic heart fail-ure.

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in the adult urban population of Hezhou Guangxi. Methods One thousand and two hundred urban residents (older than 18 years) from Hezhou Guangxi were randomly selected using a random sampling. All the residents were interviewed. Their morning spot urine were tested to determine albumin to ereatinine ratio (abnormal:≥30 mg/g), and renal function [abnomal: eMDRD <60 ml·min-1·(1.73 m2)-1] was assessed. Morning spot urine dipstick of hematuria (abnormal:≥1 +) was confirmed by microscopy (abnormal: 3 red blood cells/HP). The associations among demographic characteristics, health eharacteristies and indicators of kidney damage were examined. Results Eligible data of 1069 subjects were enrolled in the study. The prevalence of albuminuria was 7.5%, hematuria 4.8%, and reduced eGFR 3.6%. The prevalence of kidney disease was 14.4% and the recognition was 1.4%. Age (OR 1.022, 95%CI 1.008-1.035), gender (OR 2.249, 95%CI 1.502-3.367), diabetes mellitus (OR 7.422, 95%CI 3.985-13.825) and hypertension (OR 4.397, 95% CI 2.601-7.432) were independently associated with CKD. Conclusions The prevalence of chronic kidney disease is 14.4% and the recognition is 1.4% in adult urban population of Hezhou Guangxi. Independent risk factors associated with chronic kidney disease are age, gender, diabetes mellitus and hypertension which is similar to those in developed countries and domestic big cities.