Objective To explore the application value of manual purse-string suture in esophageal jejunum tubular anastomosis in total laparoscopic total gastrectomy.Methods A retrospective cohort study was conducted to collect the clinical data of 41 patients with gastric cancer who underwent laparoscopic total gastrectomy in the Department of Gastrointestinal Surgery,Jingmen Central Hospital from January 2020 to December 2023.Among them,22 cases underwent total laparoscopic radical total gastrectomy with manual purse-string suture(total laparoscopic group),Nineteen patients underwent traditional laparoscopic-assisted total gastrectomy(laparoscopic-assisted group).Results 41 patients were successfully completed surgery,no conversion to laparotomy,no perioperative death.The operation time of the total laparoscopic group and laparoscopic-assisted group was 397.50(310-540)minutes and 350(250-440)minutes.The intraoperative blood loss was 50(10-400)ml and 100(20-200)ml.The incision length was 5(4-5)cm and 8(6-10)cm.The duration of postoperative analgesic use was 4(3-5)days and 5(3-5)days.The hospitalization days were 23(18-37)days and 26(13-34)days,respectively,and the difference was statistically significant(P＜0.05).There was no significant difference in the number of lymph node dissection,postoperative abdominal bleeding,postoperative anastomotic leakage,postoperative anastomotic stenosis,postoperative pulmonary infection,postoperative first exhaust time and postoperative ambulation time between the two groups(P＞0.05).Conclusion It is safe and feasible to perform esophagojejunostomy by hand purse-string suture in totally laparoscopic total gastrectomy.Compared with traditional laparoscopic-assisted total gastrectomy,it has smaller incision,less intraoperative blood loss,less postoperative pain,shorter hospitalization time,but longer operation time.

Objective To explore the application value of manual purse-string suture in esophageal jejunum tubular anastomosis in total laparoscopic total gastrectomy.Methods A retrospective cohort study was conducted to collect the clinical data of 41 patients with gastric cancer who underwent laparoscopic total gastrectomy in the Department of Gastrointestinal Surgery,Jingmen Central Hospital from January 2020 to December 2023.Among them,22 cases underwent total laparoscopic radical total gastrectomy with manual purse-string suture(total laparoscopic group),Nineteen patients underwent traditional laparoscopic-assisted total gastrectomy(laparoscopic-assisted group).Results 41 patients were successfully completed surgery,no conversion to laparotomy,no perioperative death.The operation time of the total laparoscopic group and laparoscopic-assisted group was 397.50(310-540)minutes and 350(250-440)minutes.The intraoperative blood loss was 50(10-400)ml and 100(20-200)ml.The incision length was 5(4-5)cm and 8(6-10)cm.The duration of postoperative analgesic use was 4(3-5)days and 5(3-5)days.The hospitalization days were 23(18-37)days and 26(13-34)days,respectively,and the difference was statistically significant(P＜0.05).There was no significant difference in the number of lymph node dissection,postoperative abdominal bleeding,postoperative anastomotic leakage,postoperative anastomotic stenosis,postoperative pulmonary infection,postoperative first exhaust time and postoperative ambulation time between the two groups(P＞0.05).Conclusion It is safe and feasible to perform esophagojejunostomy by hand purse-string suture in totally laparoscopic total gastrectomy.Compared with traditional laparoscopic-assisted total gastrectomy,it has smaller incision,less intraoperative blood loss,less postoperative pain,shorter hospitalization time,but longer operation time.

To investigate the safety and feasibility of gasless total endoscopic resection of deep lobe parotid gland tumors via a postauricular hairline plus temporal approach. The approach was designed as: a 4 to 5 cm main incision was designed at the postauricular hairline, and a 0.5 cm auxiliary incision was designed in the temporal hairline. The operating cavity was established with the assistance of a special retractor. "Anterograde" dissection of the facial nerve was performed throughout the procedure, along with partial or total gland removal of the tumor. All 16 operations were successfully completed without conversion to open surgery. During the operation, the trunk and branches of the facial nerve were completely preserved, the tumor was completely removed, and the incision healed. Six patients had mild facial paralysis after operation, and recovered completely after 3 to 6 months. There was no salivary fistula, Frey syndrome, infection, or other complications. The postoperative incision was concealed and the aesthetic effect was good. The postauricular hairline plus temporal approach gasless total endoscopic parotidectomy is safe and feasible. This technique can achieve the complete dissection of the total trunk to the branches of the facial nerve, and has good access to the tumors located in any part of the parotid gland region. On the basis of radical resection of the tumor, it achieves minimally invasive and aesthetic improvement.

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.
Mice ; Animals ; Lip/innervation* ; Prospective Studies ; Mandibular Nerve/pathology* ; Sensation/physiology* ; Trigeminal Nerve Injuries/pathology*

To describe a novel particles surface display system which is consisted of gram-positive enhancer matrix (GEM) particles and anchor proteins for bacteria-like particles vaccines, we treated Lactobacillus rhamnosus GG bacteria with 10% heated-TCA for preparing GEM particles, and then identified the harvested GEM particles by electron microscopy, RT-PCR and SDS-PAGE. Meanwhile, Escherichia coli was induced to express hybrid proteins PA3-EGFP and P60-EGFP, and GEM particles were incubated with them. Then binding of anchor proteins were determined by Western blotting, transmission electron microscopy, fluorescence microscopy and spectrofluorometry. GEM particles preserved original size and shape, and proteins and DNA contents of GEM particles were released substantially. The two anchor proteins both had efficiently immobilized on the surface of GEM. GEM particles that were bounded by anchor proteins were brushy. The fluorescence of GEM particles anchoring PA3 was slightly brighter than P60, but the difference was not significant (P>0.05). GEM particles prepared from L. rhamnosus GG have a good binding efficiency with anchor proteins PA3-EGFP and P60-EGFP. Therefore, this novel foreign protein surface display system could be used for bacteria-like particle vaccines.

Objective: To investigate the hospital employee satisfaction and trustworthiness in the background of the trusteeship mode and to find out the problems after trusteeship.Methods: Minnesota satisfaction questionnaire (MSQ) and the self-made questionnaire were used to conduct the survey.Results: The overall employee satisfaction (3.80±0.86) and trustworthiness (3.95±0.77)were higher.The highest level of trustworthiness concerned the cultural connotation (84.8%) followed by the management concept (82.8%) for overall satisfaction.The lowest level of employee satisfaction concerned income and workload (53.7%), followed by the working conditions and environment (55.3%).The administrative staff satisfaction was higher compared to that of medical staff (p=0.001), which showed significant statistical differences.Conclusions: The hospital has made some achievements after the trusteeship system reform, however, it still needs improvement and further strengthening in many aspects.The hospital must always keep abreast of the demands of workforce and improve the staff satisfaction so as to promote its continuous and sustainable development.

OBJECTIVETo evaluate the diagnostic value of magnetic resonance (MR) imaging in the diagnosis of mandibular invasion caused by oral cancers.

METHODSMedline, EMBASE, SIGLE, and Chinese biomedical literature database were searched electronically. Manual searching for 19 relevant Chinese journals was also performed. Two reviewers evaluated the literature and extracted the data. Meta-Disc 1.4 was chosen to conduct the sensitivity (SEN), specificity (SPE), and 95% confidence interval (95%CI).

RESULTSTwelve studies with a total of 476 patients, namely, 5 prospective studies and 7 retrospective studies, were included. All the studies had unclear risk of bias. Meta-analysis result showed that the combination of SEN of MR in diagnosing mandibular invasion was 0.779 (95%CI: 0.719-0.831), combination of SPE was 0.823 (95%CI: 0.767-0.870), positive likelihood ratio was 3.442 (95%CI: 2.181-5.431), negative likelihood ratio was 0.286 (95%CI: 0.181- 0.451), and diagnostic odds ratio was 25.702 (95%CI: 13.406-49.273). The area under curve was 0.903 9 and Q* was 0.835 4. Meta-analysis was not processed when diagnosing mandibular medullary invasion because only two studies with 55 patients had been reported. The SEN was 0.838, and the SPE was 0.722.

CONCLUSIONMR is efficient and has clinical value in the diagnosis of mandibular invasion caused by oral cancer.

Anterolateral thigh flap is perfect for reconstructing maxillofacial soft tissue defects. This tissue has been widely used by clinicians, but often causes operation difficulties because of vascular variation. In this paper, we report a case where anteromedial thigh was used as new donor site when the vascular anatomic variation of anterolateral thigh perforator flap induced a failure in the flap harvest. Moreover, this paper discusses the anatomy and application of anteromedial thigh flap.
Humans ; Maxillofacial Abnormalities ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Thigh ; surgery

BACKGROUND:Absorbable colagen membrane can be theoreticaly applied to secondary alveolar bone grafting in alveolar cleft surgery, which can improve the bone preservation and slow bone resorption. However, there is stil no unified conclusion.
OBJECTIVE:To assess the efficacy and safety of absorbable colagen membrane for secondary alveolar bone grafting viaa systematic review.
METHODS:MEDLINE, EMBASE, CBM and CAJD were searched for eligible articles addressing clinical randomized controled or controled trials of absorbable colagen membrane for secondary alveolar bone grafting. Test group received bone grafting with absorbable colagen membrane and control group only received bone grafting. Meta-analysis on the clinical success rate of bone grafting and incidence of complications in the recipient region was delivered with Revman 5.3.
RESULTS AND CONCLUSION:Five clinical trials, involving 416 cleft sites and 387 participants, were included. Two had high risk of bias and the rest had unclear risk of bias. If “the height of new bone is≥ 50% of alveolar height” was adopted as clinical success, the clinical success rate of the test group was significantly higher than that of the control group (P=0.002, relative risk value=1.33, 95% confidence interval [1.11, 1.60]). If “the height of new bone is≥ 75% of alveolar height” was chosen as clinical success, the clinical success rate of the test group was higher than that of the control group, but there was no significant difference between the two groups (P=0.06, relative risk value=1.40, 95% confidence interval [0.99, 1.99]). For safety, the use of absorbable colagen membrane could not increase the complications incidence (P=0.35, relative risk value=0.66, 95% confidence interval [0.28, 1.58]). So, the use of absorbable colagen membrane is safe to improve the clinical success rate of secondary alveolar bone grafting in alveolar cleft surgery. More randomized controled trials should be considered to reinforce the conclusion.

BACKGROUND:There are numerous clinical studies on comparing absorbable internal fixation system and titanium metal internal fixation system in maxilofacial fractures; however, the systematic reviews and Meta-analysis in this field are rare. OBJECTIVE:To compare the clinical effect of absorbable internal fixation system and titanium internal fixation system in maxilofacial fractures through systematic review and Meta-analysis. MATERIALS AND METHODS:The randomized controled trials and controled clinical trials regarding the application of absorbable internal fixation system and titanium internal fixation system in maxilofacial fractures were electronicaly retrieved from Medline, Embase, the Cochrane Central Register of Controled Trials, China Biology Medicine disc, and China Academic Journal Network Publishing Database using the keywords. Meta-analysis was conducted using Revman 5.3 software. RESULTS AND CONCLUSION:Thirteen clinical studies were included, and totaly 1 718 patients were involved. The Meta-analysis results showed that the removal rate of implants in the absorbable internal fixation system group was significantly lower than that in the titanium internal fixation group (P=0.000 2); there were no significant differences in the healing rate of fracture I stage, the incidence of insufficient fixation in fracture site and the incidence of long-term complications between these two groups. These results demonstrate that the efficiency and safety of absorbable internal fixation system in maxillofacial fracture is satisfactory, and can reduce the proportion of secondary surgical removal of the implant. More randomized controlled trials should be conducted to confirm this conclusion.