1.Comparison of clinical outcomes of forearm radial flap and anterolateral thigh flap for repairing soft tissue defects after oral cancer resection
Jiang ZHU ; Wushuang XU ; Zihan MA ; Yucheng XIANG ; Wanying SHI ; Senbin WU ; Donghui SONG
Chinese Journal of Plastic Surgery 2024;40(9):992-1001
Objective:To compare the efficacy of radial forearm flap and anterolateral thigh flap in repairing soft tissue defects after oral cancer surgery and to explore their indications.Methods:A retrospective analysis was conducted on clinical data of patients with oral cancer treated at the Department of Stomatology, Affiliated Hospital of Nantong University, from May 2019 to February 2023. Patients were divided into two groups based on the repair method: the radial forearm flap group and the anterolateral thigh flap group. The groups were compared in the following aspects. (1) Surgical parameters including defect area after oral cancer resection, flap area, flap preparation time, operation time, and length of hospital stay. (2) Inflammatory markers (interleukin-6 and C-reactive protein levels) measured 1 day before surgery and 1 day after surgery. (3) Flap survival rate was calculated. (4) Complication rates was calculated in the flap donor area and infection rates in the oral recipient area within 6 months postoperatively. (5) Six months postoperatively, the patient’s oral function was assessed by a physician using the University of Washington quality of life scale (UW-QOL). The evaluation included assessments of oral opening, speech, and eating functions. Each parameter was scored on a scale of 0 to 10 (higher scores indicated better recovery). (6) Quality of life was assessed using the 36-item short form health survey scale(SF-36) at 2, 4 and 6 months postoperatively, with scores ranging from 0 to 100 (higher scores indicated better quality of life). (7) Patient satisfaction was assessed at 6 months postoperatively, with satisfaction levels categorized as satisfied, basically satisfied, and dissatisfied. The satisfaction rate was calculated as (satisfied + basically satisfied ) cases / total cases in each group × 100%. Statistical analysis was performed using SPSS 22.0. Measurement data were expressed as Mean±SD, and comparisons between groups were conducted using t-tests. Count data were expressed as cases and (or) percentages, and comparisons were made using chi-square test. P<0.05 was considered statistically significant. Results:The radial forearm flap group included 48 cases (32 males, 16 females), aged (49.3±5.0) years, with a body mass index (BMI) of (23.0±1.1) kg/m 2 and a disease course of (6.5±2.1) months. The group had 21 cases of tongue cancer, 12 of floor of mouth cancer, and 15 of buccal cancer, including 40 squamous cell carcinomas and 8 basal cell carcinomas. The anterolateral thigh flap group included 32 cases (20 males, 12 females), aged (50.1±5.0) years, with a BMI of (23.0±1.0) kg/m 2 and a disease course of (7.0±2.2) months. The group had 16 cases of tongue cancer, 7 cases of floor of mouth cancer, and 9 cases of buccal cancer, including 27 squamous cell carcinomas and 5 basal cell carcinomas. There were no significant differences in gender, age, BMI, disease course, tumor location, or pathological type between the two groups ( P>0.05). The defect area after oral cancer resection was smaller in the radial forearm flap group[ (39.0±1.3) cm 2 ] compared to the anterolateral thigh flap group[ (40.3±2.2) cm 2] ( t=3.32, P=0.001). There were no significant differences in flap area, flap preparation time, or length of hospital stay between the two groups ( P>0.05). The operation time was shorter in the radial forearm flap group [(5.1±1.1) h] compared to the anterolateral thigh flap group [(6.8±2.8) h] ( t=0.26, P<0.001). There were no significant differences in interleukin-6 and C-reactive protein levels between the two groups 1 day before surgery and 1 day after surgery ( P>0.05). The flap survival rates were 97.9% (47/48) in the radial forearm flap group and 93.8% (30/32) in the anterolateral thigh flap group, with no significant difference( P>0.05). Postoperative donor site complications mainly included infection, pigmentation, itching, etc. The overall incidence of complications in the donor site of the radial forearm flap [33.3% (16/48)] was higher than that in the anterolateral thigh flap group [12.5% (4/32)], and the difference was statistically significant ( χ2=4.44, P=0.035). There was no significant difference in infection rates in the oral recipient area between the two groups ( P>0.05). Six months postoperatively, the average scores for oral opening, speech, and eating functions were above 7 in both groups, with no significant differences ( P>0.05). Quality of life scores improved over time in both groups, with average scores above 90 at 6 months postoperatively, and no significant differences at any time point ( P>0.05). The patient satisfaction rate was 91.7% (44/48) in the radial forearm flap group and 90.6% (29/32) in the anterolateral thigh flap group, with no significant difference ( P>0.05). Conclusion:Both radial forearm flap and anterolateral thigh flap can effectively repair soft tissue defects after oral cancer resection, significantly improving patients’oral function. The anterolateral thigh flap provides sufficient tissue volume and is suitable for patients with larger defect areas. The radial forearm flap is suitable for patients with a smaller defect area after oral cancer resection. Its surgical procedure is relatively less complex and offers an advantage in reducing surgery time. However, the donor site complications are higher with the radial forearm flap compared to the anterolateral thigh flap.
2.Comparison of clinical outcomes of forearm radial flap and anterolateral thigh flap for repairing soft tissue defects after oral cancer resection
Jiang ZHU ; Wushuang XU ; Zihan MA ; Yucheng XIANG ; Wanying SHI ; Senbin WU ; Donghui SONG
Chinese Journal of Plastic Surgery 2024;40(9):992-1001
Objective:To compare the efficacy of radial forearm flap and anterolateral thigh flap in repairing soft tissue defects after oral cancer surgery and to explore their indications.Methods:A retrospective analysis was conducted on clinical data of patients with oral cancer treated at the Department of Stomatology, Affiliated Hospital of Nantong University, from May 2019 to February 2023. Patients were divided into two groups based on the repair method: the radial forearm flap group and the anterolateral thigh flap group. The groups were compared in the following aspects. (1) Surgical parameters including defect area after oral cancer resection, flap area, flap preparation time, operation time, and length of hospital stay. (2) Inflammatory markers (interleukin-6 and C-reactive protein levels) measured 1 day before surgery and 1 day after surgery. (3) Flap survival rate was calculated. (4) Complication rates was calculated in the flap donor area and infection rates in the oral recipient area within 6 months postoperatively. (5) Six months postoperatively, the patient’s oral function was assessed by a physician using the University of Washington quality of life scale (UW-QOL). The evaluation included assessments of oral opening, speech, and eating functions. Each parameter was scored on a scale of 0 to 10 (higher scores indicated better recovery). (6) Quality of life was assessed using the 36-item short form health survey scale(SF-36) at 2, 4 and 6 months postoperatively, with scores ranging from 0 to 100 (higher scores indicated better quality of life). (7) Patient satisfaction was assessed at 6 months postoperatively, with satisfaction levels categorized as satisfied, basically satisfied, and dissatisfied. The satisfaction rate was calculated as (satisfied + basically satisfied ) cases / total cases in each group × 100%. Statistical analysis was performed using SPSS 22.0. Measurement data were expressed as Mean±SD, and comparisons between groups were conducted using t-tests. Count data were expressed as cases and (or) percentages, and comparisons were made using chi-square test. P<0.05 was considered statistically significant. Results:The radial forearm flap group included 48 cases (32 males, 16 females), aged (49.3±5.0) years, with a body mass index (BMI) of (23.0±1.1) kg/m 2 and a disease course of (6.5±2.1) months. The group had 21 cases of tongue cancer, 12 of floor of mouth cancer, and 15 of buccal cancer, including 40 squamous cell carcinomas and 8 basal cell carcinomas. The anterolateral thigh flap group included 32 cases (20 males, 12 females), aged (50.1±5.0) years, with a BMI of (23.0±1.0) kg/m 2 and a disease course of (7.0±2.2) months. The group had 16 cases of tongue cancer, 7 cases of floor of mouth cancer, and 9 cases of buccal cancer, including 27 squamous cell carcinomas and 5 basal cell carcinomas. There were no significant differences in gender, age, BMI, disease course, tumor location, or pathological type between the two groups ( P>0.05). The defect area after oral cancer resection was smaller in the radial forearm flap group[ (39.0±1.3) cm 2 ] compared to the anterolateral thigh flap group[ (40.3±2.2) cm 2] ( t=3.32, P=0.001). There were no significant differences in flap area, flap preparation time, or length of hospital stay between the two groups ( P>0.05). The operation time was shorter in the radial forearm flap group [(5.1±1.1) h] compared to the anterolateral thigh flap group [(6.8±2.8) h] ( t=0.26, P<0.001). There were no significant differences in interleukin-6 and C-reactive protein levels between the two groups 1 day before surgery and 1 day after surgery ( P>0.05). The flap survival rates were 97.9% (47/48) in the radial forearm flap group and 93.8% (30/32) in the anterolateral thigh flap group, with no significant difference( P>0.05). Postoperative donor site complications mainly included infection, pigmentation, itching, etc. The overall incidence of complications in the donor site of the radial forearm flap [33.3% (16/48)] was higher than that in the anterolateral thigh flap group [12.5% (4/32)], and the difference was statistically significant ( χ2=4.44, P=0.035). There was no significant difference in infection rates in the oral recipient area between the two groups ( P>0.05). Six months postoperatively, the average scores for oral opening, speech, and eating functions were above 7 in both groups, with no significant differences ( P>0.05). Quality of life scores improved over time in both groups, with average scores above 90 at 6 months postoperatively, and no significant differences at any time point ( P>0.05). The patient satisfaction rate was 91.7% (44/48) in the radial forearm flap group and 90.6% (29/32) in the anterolateral thigh flap group, with no significant difference ( P>0.05). Conclusion:Both radial forearm flap and anterolateral thigh flap can effectively repair soft tissue defects after oral cancer resection, significantly improving patients’oral function. The anterolateral thigh flap provides sufficient tissue volume and is suitable for patients with larger defect areas. The radial forearm flap is suitable for patients with a smaller defect area after oral cancer resection. Its surgical procedure is relatively less complex and offers an advantage in reducing surgery time. However, the donor site complications are higher with the radial forearm flap compared to the anterolateral thigh flap.
3.Associations between personal fine particulate matter and blood lipid profiles: A panel study in Chinese people aged 60-69 years
Jiaonan WANG ; Tiantian LI ; Jianlong FANG ; Song TANG ; Yi ZHANG ; Fuchang DENG ; Chong SHEN ; Wanying SHI ; Yuanyuan LIU ; Chen CHEN ; Qinghua SUN ; Yanwen WANG ; Yanjun DU ; Haoran DONG ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2022;56(7):897-901
Objective:To explore the association between short-term exposures to fine particulate matter (PM 2.5) on blood lipids in the elderly. Methods:In this panel study, five repeated measurements were performed on 76 people aged 60-69 in Jinan city. Each participant had a PM 2.5 monitor for 72 hours before each health examination, including a questionnaire survey, physical examination, and biological sample collection. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were examined, and non-HDL-C concentrations were calculated by subtracting HDL-C from TC. The generalized linear mixed-effects model was used to quantify the association of personal PM 2.5 exposure at different lag with blood lipids and dyslipidemia. Results:The age of 70 participants was (65.0±2.8) years, of which 48.6% (34/70) were males. The BMI of participants was (25.0±2.5) kg/m 2. Their TC, TG, LDL-C, HDL-C, and non-HDL-C concentrations were (5.75±1.32), (1.55±0.53), (3.27±0.94), (1.78±0.52), and (3.97±1.06) mmol/L, respectively. Generalized linear mixed-effects model showed that after adjusting for confounding factors, at lag 72 hours, each 10 μg/m 3 increase in PM 2.5 was associated with the percentage change in TC, LDL-C, HDL-C and non-HDL-C about 1.77% (95% CI: 1.22%-2.32%), 1.90% (95% CI: 1.18%-2.63%), 1.99% (95% CI: 1.37%-2.60%) and 1.74% (95% CI: 1.11%-2.37%), and the OR values (95% CI) of hypercholesterolemia, hypertriglyceridemia and hyperbetalipoproteinemia were 1.11 (1.01-1.22), 1.33 (1.03-1.71) and 1.15 (1.01-1.31), respectively. Conclusion:There is a significant association of short-term PM 2.5 exposure with the concentration of blood lipids and the risk of dyslipidemia in the elderly.
4.Associations between personal fine particulate matter and blood lipid profiles: A panel study in Chinese people aged 60-69 years
Jiaonan WANG ; Tiantian LI ; Jianlong FANG ; Song TANG ; Yi ZHANG ; Fuchang DENG ; Chong SHEN ; Wanying SHI ; Yuanyuan LIU ; Chen CHEN ; Qinghua SUN ; Yanwen WANG ; Yanjun DU ; Haoran DONG ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2022;56(7):897-901
Objective:To explore the association between short-term exposures to fine particulate matter (PM 2.5) on blood lipids in the elderly. Methods:In this panel study, five repeated measurements were performed on 76 people aged 60-69 in Jinan city. Each participant had a PM 2.5 monitor for 72 hours before each health examination, including a questionnaire survey, physical examination, and biological sample collection. Serum triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were examined, and non-HDL-C concentrations were calculated by subtracting HDL-C from TC. The generalized linear mixed-effects model was used to quantify the association of personal PM 2.5 exposure at different lag with blood lipids and dyslipidemia. Results:The age of 70 participants was (65.0±2.8) years, of which 48.6% (34/70) were males. The BMI of participants was (25.0±2.5) kg/m 2. Their TC, TG, LDL-C, HDL-C, and non-HDL-C concentrations were (5.75±1.32), (1.55±0.53), (3.27±0.94), (1.78±0.52), and (3.97±1.06) mmol/L, respectively. Generalized linear mixed-effects model showed that after adjusting for confounding factors, at lag 72 hours, each 10 μg/m 3 increase in PM 2.5 was associated with the percentage change in TC, LDL-C, HDL-C and non-HDL-C about 1.77% (95% CI: 1.22%-2.32%), 1.90% (95% CI: 1.18%-2.63%), 1.99% (95% CI: 1.37%-2.60%) and 1.74% (95% CI: 1.11%-2.37%), and the OR values (95% CI) of hypercholesterolemia, hypertriglyceridemia and hyperbetalipoproteinemia were 1.11 (1.01-1.22), 1.33 (1.03-1.71) and 1.15 (1.01-1.31), respectively. Conclusion:There is a significant association of short-term PM 2.5 exposure with the concentration of blood lipids and the risk of dyslipidemia in the elderly.
5.Effect of miR-581 on Autophagy of Ovarian Cancer SKOV3 Cells by Regulating FOXO1
Haining GAO ; Ruixia BAI ; Pengwei ZHAO ; Wanying SONG ; Xuan LIN
Cancer Research on Prevention and Treatment 2022;49(5):403-407
Objective To explore the effect and mechanism of miR-581 on the autophagy of ovarian cancer SKOV3 cells. Methods miR-581 mimics and miR-581 NC were transfected into SKOV3 cells, and the transfection efficiency was detected by qRT-PCR. After successful transfection, Western blot was used to detect autophagy-related proteins expression in SKOV3 cells. TargetScanHuman database predicted miR-581 target genes, and Western blot verified the role of miR-581 and target genes. Results Overexpression of miR-581 significantly inhibited the expression of autophagy-related proteins LC3 Ⅱ and Beclin1 (
6.Analysis of the incidence and mortality trends of esophageal cancer in the cancer registration areas of Heilongjiang province from 2013 to 2017
Huixin SUN ; Maoxiang ZHANG ; Haihan JIA ; Wanying WANG ; Bingbing SONG
Cancer Research and Clinic 2021;33(8):591-595
Objective:To explore the incidence and mortality of esophageal cancer in the cancer registration areas of Heilongjiang province from 2013 to 2017 and their trends of change over time.Methods:The esophageal cancer incidence, mortality and population data reported by 12 cancer registration areas of Heilongjiang province were collected. Among them, the data of 11 areas met the check standards, including 7 cities above the prefecture level (abbreviated as urban area), 4 counties and county-level cities (abbreviated as rural area). The crude incidence and mortality rates of esophageal cancer in 11 cancer registration areas of Heilongjiang province from 2013 to 2017, and their standardized rates by Chinese population (adjusted according to the standard population composition of the 2000 census of China) and world population (adjusted using Segi world standard population composition), and the cumulative incidence or mortality rate from 0 to 74 years old (abbreviated as cumulative incidence or mortality rate) were calculated. Joinpoint regression was used to calculate the annual percentage change (APC) of the incidence and mortality rates, and the trend analysis was performed.Results:From 2013 to 2017, the crude incidence rate of esophageal cancer in the cancer registration areas of Heilongjiang province was 6.40/100 000, the standardized incidence rate by Chinese population was 3.63/100 000, and the cumulative incidence rate was 0.44%. The crude incidence rate of esophageal cancer in males (11.61/100 000) was higher than that in females (1.27/100 000). The crude incidence rate of esophageal cancer in rural area (6.27/100 000) was lower than that in urban area (6.71/100 000). From 2013 to 2017, the crude mortality rate of esophageal cancer in the cancer registration areas of Heilongjiang province was 5.32/100 000, the standardized mortality rate by Chinese population was 3.01/100 000, and the cumulative mortality rate was 0.35%. The crude mortality rate of esophageal cancer in males (9.56/100 000) was higher than that in females (1.15/100 000). The crude mortality rate of esophageal cancer in rural area (5.13/100 000) was lower than that in urban area (5.39/100 000). Joinpoint regression analysis showed that from 2013 to 2017, the incidence and mortality rates of esophageal cancer in the entire population and males had an increasing trend, but the differences were not statistically significant (all P > 0.05), and the standardized incidence rate by Chinese population in females had a downward trend, and the difference was statistically significant (APC = -7.92, 95% CI -11.52- -4.21, P < 0.01). Conclusions:The incidence and mortality rates of esophageal cancer in Heilongjiang province have been increasing in recent years, and the burden of disease is still heavy. In the male population, the primary prevention, early detection and early treatment of esophageal cancer should be paid more attention.
7.Incidence and Mortality of Lung Cancer in Heilongjiang Cancer Registries, 2013-2017
Wanying WANG ; Huixin SUN ; Maoxiang ZHANG ; Haihan JIA ; Bingbing SONG
Cancer Research on Prevention and Treatment 2021;48(11):1017-1022
Objective To analyze the incidence, mortality and time trend of lung cancer in Heilongjiang Cancer Registries from 2013 to 2017. Methods We calculated the incidence (mortality) rate and age-standardized incidence (mortality) rate of lung cancer in Heilongjiang Cancer Registries from 2013 to 2017. Chinese population census in 2000 and World Segi's standard population were used for age-standardization. Annual percentage change (APC) was calculated using Joinpoint software. Results The incidence of lung cancer in Heilongjiang Cancer Registries from 2013 to 2017 was 63.44/105 and ASR China was 36.14/105. The incidence of lung cancer in males (78.08/105) was higher than that in females (49.04/105). The incidence of lung cancer in rural areas (65.54/105) was higher than that in urban areas (58.20/105). From 2013 to 2017, the mortality rate of lung cancer in Heilongjiang Cancer Registries was 57.02/105, and ASR China was 32.53/105. The mortality rate of lung cancer in males (69.92/105) was higher than that in females (44.40/105). The mortality rate of lung cancer in rural areas (60.68/105) was higher than that in urban areas (48.02/105). The incidence of lung cancer in the 55-year-old age group showed a downward trend (APC=-5.0%,
8. Association of ambient fine particulate matters with anxiety in middle-aged and elderly people
Wanying SHI ; Yi ZHANG ; Peng DU ; Chen CHEN ; Jiaonan WANG ; Jianlong FANG ; Jie BAN ; Yuebin LYU ; Zonghao DU ; Qiong WANG ; Song TANG ; Tiantian LI ; Xiaoming SHI
Chinese Journal of Preventive Medicine 2019;53(1):71-75
Objective:
To investigate the association of ambient fine particulate matters (PM2.5) exposure with anxiety in middle-aged and elderly people in China.
Methods:
Using a stratified random sampling method, 5 997 middle-aged and elderly people (aged 40-89) who resided in the region for more than 2 years and had no hearing or language impairment were selected from 32 districts/counties in the key areas for air pollution prevention and control in China from October 10th, 2017 to February 7th, 2018. Information about demographic characteristics, socioeconomic factors and health status were collected by questionnaire survey and physical examination. The anxiety symptoms were assessed by 7-item Generalized Anxiety Disorder Scales. Three-year moving average concentrations of PM2.5 were calculated to estimate exposure level. The multivariate logistic regression model was conducted to assess the association between PM2.5 exposure and anxiety. The interaction of age, gender, overweight, education, smoking, drinking and chronic diseases was also analyzed by likelihood ratio test.
Results:
There were 2 995 (49.94%) males subjects, 4 092 (68.23%) subjects with education of secondary school or above and 2 576 (42.95%) subjects with self-reported chronic diseases among the 5 997 middle-aged and elder participants. The prevalence of anxiety was 6.64% (
9.Study of niacin skin flushing response for the diagnosis of major depressive disorder.
Yanqun ZHENG ; Yan WANG ; Wanying LIU ; Fuxu ZHANG ; Mo ZHU ; Zhenhua SONG ; Yao HU ; Tianhong ZHANG ; Xiaohua. LIU
Chinese Journal of Nervous and Mental Diseases 2018;44(12):710-715
Objective To investigate the difference of niacin skin flush response between patients with major depressive disorder (MDD) and healthy controls (HCs), and its sensitivity and specificity for the diagnosis of MDD. Methods Twenty-one untreated patients with MDD and 28 age- and gender-matched HCs were enrolled in this study. The severity of depressive symptoms was assessed mainly by using the 17-item Hamilton Depression Rating Scale (HDRS-17). Methyl Nicotinate (MN) solution at 8 different concentrations (10-5 mol/L, 10-4 mol/L, 10-3.5 mol/L, 10-3 mol/L, 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L, 10-1 mol/L) were applied on subjects' forearms. Signals of blood flow were collected using the Doppler Laser Flowmetry to detect the skin flushing of the test. Results Under the concentrations of 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L and 10-1 mol/L MN solution, the blood flow was significantly higher in depressive patients than in HCs (P<0.01). The MN sensitivity (logEC50) was inversely correlated to the severity of depressive symptoms (r=-0.57, P<0.05). ROC curve analysis implied that the maximum blood flow (MBF) caused by the niacin skin flush response, could efficiently discriminate MDD from HCs (AUC=0.90, P<0.01). Conclusion The presence of enhanced niacin skin flush response may be helpful in the diagnosis of MDD.
10.Effect of the public hospital trusteeship based on the employee satisfaction
Yang LIU ; Chunjie ZHANG ; Wei CAO ; Binbin SU ; Yiheng HE ; Ying ZANG ; Xinqi SONG ; Wanying MU ; Zhifeng WANG
Chinese Journal of Health Policy 2017;10(3):24-28
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.

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