Objective:To evaluate a transhiatal tunnel flap designed to reconstruct the cardiac functional structure in proximal gastric cancer patients in our center.Methods:A descriptive case study method was used to select the data of 11 patients undergoing surgery for upper gastric cancer from Jan to Jul 2024. After laparoscopic dissection is completed, the esophagus is transected 2 cm from the upper edge of the tumor and the specimen is removed. The distance from the lower edge of the tumor is 5 cm. The cutting width is 4 cm, and the length of sleeve distal stump stomach is 20 cm. A seromuscular flap tunnel was made with a length of 2 cm and a width of 2 cm, 2 cm away from the top of the remnant stomach. The digestive tract was reconstructed using the Overlap hybridization method.Results:The median operation time was 175 (139-285) minutes. The median muscle flap production time and reconstruction time was 10.5 (5.5-21.0) minutes and 15.0 (11.8-33.6) minutes, respectively. The median blood loss is 50 (20-100) ml. The median postoperative hospitalization was 8 (6-25) days. The median tumor size was 2.5 (1.0-4.0) cm, and 31 (15-52) lymph nodes were dissected. The median follow-up after surgery was 3.5 (0.7-6.0) months, and no tumor recurrence or metastasis was found. Postoperative anastomotic leakage (Clavien-Dindo grade Ⅱ) occurred in one case, and there was no perioperative death. The Visick score of the whole group was 1 point in 8 cases and 2 points in 3 cases, and there was no anastomotic stenosis. Reflux esophagitis (Los Angeles classification grade B) was found in 1 case after gastroscopy, and the symptoms were relieved by conservative treatment.Conclusion:The transhiatal tunnel flap arthroplasty method has high surgical safety, low reconstruction difficulty, and an reliable anti-reflux effect.

Objective:To evaluate a transhiatal tunnel flap designed to reconstruct the cardiac functional structure in proximal gastric cancer patients in our center.Methods:A descriptive case study method was used to select the data of 11 patients undergoing surgery for upper gastric cancer from Jan to Jul 2024. After laparoscopic dissection is completed, the esophagus is transected 2 cm from the upper edge of the tumor and the specimen is removed. The distance from the lower edge of the tumor is 5 cm. The cutting width is 4 cm, and the length of sleeve distal stump stomach is 20 cm. A seromuscular flap tunnel was made with a length of 2 cm and a width of 2 cm, 2 cm away from the top of the remnant stomach. The digestive tract was reconstructed using the Overlap hybridization method.Results:The median operation time was 175 (139-285) minutes. The median muscle flap production time and reconstruction time was 10.5 (5.5-21.0) minutes and 15.0 (11.8-33.6) minutes, respectively. The median blood loss is 50 (20-100) ml. The median postoperative hospitalization was 8 (6-25) days. The median tumor size was 2.5 (1.0-4.0) cm, and 31 (15-52) lymph nodes were dissected. The median follow-up after surgery was 3.5 (0.7-6.0) months, and no tumor recurrence or metastasis was found. Postoperative anastomotic leakage (Clavien-Dindo grade Ⅱ) occurred in one case, and there was no perioperative death. The Visick score of the whole group was 1 point in 8 cases and 2 points in 3 cases, and there was no anastomotic stenosis. Reflux esophagitis (Los Angeles classification grade B) was found in 1 case after gastroscopy, and the symptoms were relieved by conservative treatment.Conclusion:The transhiatal tunnel flap arthroplasty method has high surgical safety, low reconstruction difficulty, and an reliable anti-reflux effect.

Objective:To investigate the management of granulation tissue during surgery for infected congenital preauricular fistula and to assess the surgical outcomes. Methods:To summarize the surgical methods and the treatment of granulation methods in 140 cases of congenital preauricular fistula during the period of infection treated in our department from January 2018 to September 2022. The study divided patients into an observation group （79 patients） undergoing fistulectomy without granulation treatment, and a control group （61 patients） where fistulectomy and granulation resection were performed concurrently.. After six months of follow-up, the wound healing, recurrence rates, and the aesthetic assessment of granulation healing were evaluated using the Stony Brook Scar Evaluation Scale（SBSES）. Results:The two surgical approaches were applied to a total of 140 patients with infected congenital preauricular fistula. There was no statistical difference in wound healing and recurrence rates between the observation group and the control group. However, the observation group exhibited smaller scars. Conclusion:In cases of infected congenital preauricular fistula, surgical removal without excising granulation tissue is feasible, leading to effective healing and lesser scar formation.
Humans ; Cicatrix ; Wound Healing ; Craniofacial Abnormalities ; Fistula/surgery* ; Treatment Outcome

OBJECTIVE To investigate the effect and mechanism of action of KRT8 small interfering RNA(si-KRT8)in exosomes derived from patient serum with hypopharyngeal carcinoma on chemosensitivity to 5-fluorouracil(5-FU)in human pharyngeal squamous cell carcinoma FaDu cell line.METHODS The cancerous tissues of hypopharyngeal cancer patients and The serum,cancerous tissues and paracancerous tissues of drug-resistant patients after treatment were collected.A 5-FU-resistant cell line of FaDu(FaDu/R)was constructed for subsequent experiments.Exosomes were isolated from patient serum by ultrafast gradient centrifugation,identified using transmission electron microscopy and Western blot(WB)techniques.si-KRT8 was encapsulated into exosomes(Exosome@si-KRT8)using electroporation technology and subsequently used to treat cells.Real-time fluorescence quantitative PCR(RT-qPCR)and WB were used to detect the expression levels of KRT8 in different tissues,exosomes after electroporation of si-KRT8,and FaDu cells,respectively.Cell counting kit-8(CCK-8),terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay,migration invasion technique and WB were used to detect the effects of Exosome@si-KRT8 on viability,apoptosis,and epithelial-mesenchymal transition of FaDu/R cells.RESULTS The expression level of KRT8 in drug-resistant tissues of hypopharyngeal carcinoma and FaDu/R cells was elevated compared with that in paraneoplastic tissues,cancer tissues and normal FaDu cells(t=15.79,P＜0.01).Isolated patient serum exosomes showed a double membrane structure and expressed both CD63 and TSG101 proteins,and KRT8 expression in exosomes was decreased after electro-transfection with si-KRT8(t=6.70,P＜0.01).Exosome@si-KRT8 inhibited KRT8 protein expression levels in FaDu/R cells(t=123.50,P＜0.01).Compared with the 5-FU group and the 5-FU+Exosome group,Exosome@si-KRT8 was able to inhibit the viability of FaDu/R cells(t=17.07,P＜0.01),promote the level of apoptosis in FaDu/R cells,and inhibit the expression of drug-resistance-associated proteins in FaDu/R cells(P-gp:t=103.20,MDR1:t=238.60,P＜0.01),and Exosome@si-KRT8 was able to suppress the expression of metastasis of FaDu/R cells(t=42.30,t=122.00,P＜0.01)and promoted the expression of E-cadherin while inhibiting the expression level of N-cadherin(t=130.80,t=83.90,P＜0.01).CONCLUSION Serum-derived exosome encapsulation of si-KRT8 enhances chemosensitivity of hypopharyngeal carcinoma cells and its mechanism of action may be related to inhibition of epithelial-mesenchymal transition.

Objective:To explore the effect of self-made negative pressure suction in auricle subluxation and avulsion injury.Methods:The clinical data of 7 patients with auricle subluxation and avulsion injury from January 2017 to February 2022 in the First People′s Hospital of Lianyungang City were retrospectively analyzed. The 7 patients were treated with self-made simple negative pressure drainage device for negative pressure suction after suture.Results:Among the 7 patients, 1 patient suffered from severe contusion and local skin necrosis, and the scar healed after local application of erythromycin eye ointment, while the other patients healed in the first stage without obvious auricular deformity.Conclusions:The negative pressure drainage is the key factor to ensure the blood supply and shape of patients with auricle subluxation and avulsion injury. The application of self-made negative pressure drainage in the treatment of subtotal auricle avulsion injury has the advantages of simple operation, improved survival rate of auricle and improved satisfactory auricle shape.

Objective:To explore the effect of nasolabial fold flap in the treatment of nasal ala subtotal defect nasal afte ala tumor operation.Methods:The clinical data of 7 nasal ala subtotal defect patients underwent nasal ala basal cell carcinoma operation in the First People′s Hospital of Lianyungang City from February 2018 to September 2020 were retrospectively analyzed.Results:Seven patients with nasal ala subtotal defect were successfully repaired with nasolabial fold flap. The patients were followed up for 19 to 52 months, the flaps survived, the color was good, the contour was not bloated, the nasal ventilation was not affected, and good results were achieved.Conclusions:The nasolabial fold flap repair of the nasal ala subtotal defect after nasal ala tumor operation has the advantages of simple method, rich materials, no need for vascular anastomosis, no need for secondary surgery, accurate effect and so on, which is suitable for clinical promotion in clinical.

Objective: To evaluate the efficacy and safety of three-dimensional electroanatomical mapping system for catheter ablation of paroxysmal supraventricular tachycardiain (PSVT) children. Methods: Clinical data from 187 children with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation in our department between January 2012 and April 2016 were analyzed. Among the patients, 91 cases were treated with traditional two-dimensional X-ray radiofrequency ablation, 96 cases were treated with radiofrequency ablation guided by three-dimensional electroanatomical mapping system. Postoperative electrocardiogram and echocardiography follow-up was performed at 1, 3, 6, 12, and 24 months. The success rate, recurrence rate, complication rate, operation time and amount of X-ray exposure were compared between the two groups. Kaplan-Meier survival curve was used to analyze the PSVT-free survival rate of the patients between the 2 groups. Results: The mean follow-up time was (739±92) days. The success rate (95.8%(92/96) vs. 94.5%(86/91), P=0.912), recurrence rate (5.4%(5/92) vs. 4.7%(4/86), P=0.807), complication rate (4.2%(4/96) vs. 5.5%(5/91), P=0.379), operation time ((73±31)min vs. (79±36)min, P=0.124) were similar between the two groups. However, X-ray exposure time ((8.1±2.9)min vs. (21.3±8.4)min, P=0.026), amount of X-ray ((23±11)mGy vs. (58±23)mGy, P=0.013) were significantly lower in the three-dimensional electroanatomical mapping system group than in the traditional two-dimensional X-ray radio frequency ablation group. PSVT-free survival rate was similar between the two groups (χ²=0.060, P=0.807) . Conclusion Three-dimensional electroanatomical mapping system is safe and effective for radiofrequency ablation of paroxysmal supraventricular tachycardia in children, and can significantly reduce the amount of radiation as compared to the traditional two-dimensional X-ray radiofrequency ablation.

Objective To investigate the effect of thyroxine replacement therapy with residual subclinical hypothyroidism on the success rate of catheter ablation in elderly patients with atrial fibrillation(AF).Methods Among the consecutive patients with AF who underwent a first AF ablation in our center between 2009 and 2012,we identified 56 patients(41 paroxysmal AF,15 persistent AF)with subclinical clinical hypothyroidism after receiving thyroid hormone replacement therapy as study group.The control group consisted of 56 patients with euthyroidism and no history of thyroid dysfunction.All patients underwent catheter ablation.Results At the end of follow up,37.5%(21/56)patients were AF free after the first procedure in the study group,in comparison to 64.3%(36/56)in control group(χ2=8.655,P=0.003).Last procedure was performed in 27 patients of study group and in 15 patients of control group.After the last performed ablation,62.5%(35/56)study group patients and 80.4%(45/56)controls group patients had no recurrence(χ2=4.653,P=0.031).The major complications rate did not differ between two groups(P=0.642).Conclusions Thyroid hormone replacement therapy with residual subclinical hypothyroidism reduces catheter ablation success rate in elderly patients with atrial fibrillation.

Objective To observe the effect of combination of dexmedetomidine and sufentanil on postoperative analgesia for the highly nicotine dependent patients undergoing esophagectomy. Methods Ninety highly nicotine dependent patients undergoing esophagectomy were randomly allocated into three groups (n = 30 each): low-dose sufentanil group (Group S1), high-dose sufentanil (Group S2), dexmedetomidine and sufentanil group (Group DS). All patients of three groups received postoperative PCIA with following setting: 2 mL/h;bolus: 2 mL; lock time: 5 min; 4 hours limited: 40 mL. The scores of VAS and Ramsay, effective presses/total presses of PCIA, the consumption of sufentanil during 72 h after operation, side effects and the satisfaction degree of patients were recorded. Results Compared with those of group S2, the scores of VAS (both at rest and movement) decreased significantly in group DS from 1 h to 8 h (P<0.05). Compared with those of group S1, the scores of VAS (both at rest and movement) decreased significantly in group S2 and DS from 1 h to 72 h (P<0.05). Compared with that in group S1 and S2, the consumption of sufentanil during 72 h after operation decreased significantly in group DS (P < 0.05). Compared with those in group DS, The numbers of nausea and vomiting were significant decreased in group S1 and S2(P < 0.05). Compared with those in group S1, the remedial cases were significantly decreased in group S2 and group DS (P < 0.05). Conclusion The effect of combination of dexmedetomidine and sufentanil is superior to that of sufentanil in terms of postoperative analgesia in highly nicotine dependent male patients undergoing esophagectomy.

Objective To study the effect of acute lymphoblastic leukemia (ALL) children bone marrow mesenchymal stem cells (MSCs) on the resistance of K562cell atd mechanism in vitro.Method MSCs were obtained from AL children bone marrow after derivation, cultivation and identification.The coculture of MSCs and K562 and K562 suspension were established.Effects of MSCs on the growth of K562 cells were investigated in vivo.The two kinds of cells treated with different concentration of adriamycin (ADM) and the rate of apoptosis was evaluated by flow cytometry.Cell cycle was determined by flow cytometry.RT-PCR was used to detect Bcl-2 and Bax in K562 cells.Result Compared with the cell growth curve of K562 alone, the K562 cell co-cultured with MSCs grew slower and the exponential phase of growth was not obvious.The apoptosis index of the K562 cells co- clutured with MSCs was (9.19 ±0.53)% examined by flow cytometry, and that of the K562 cells alone was 4.00 ± 0.37% respectively( P ＜ 0.05 ).The percentage of cells at G0/G1 phase was (50.2 ± 2.26) % and that at S phase was (37.03 ± 3.50) % in the group of K562 alone, but those of the K562 cells co - cultured with MSCs were (80.95 ± 3.83) % and ( 17.40 ± 1.50)% respectively( P ＜0.05).The result of RT-PCR suggested expression of Bcl-2/Bax of the K562 cell co-cultured with MSCs was higher than K562 alone.Conclusion ALL children MSCs suppressed the growth of K562 cell in vitro.Adhesion made K562 depress sensitive to ADM.The mechanism was perhaps caused by adhesion with MSCs, K562 cell cycle was changed and related to Bcl-2 gene high level expression.