Intraoperative cell salvage (IOCS) has been widely applied as an important blood conservation measure in surgical operations. However, there is currently a lack of clinical practice guidelines for the implementation of IOCS in patients with malignant tumors. This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence. Data were derived from databases such as PubMed, Embase, the Cochrane Library and Wanfang. The guideline development team formulated recommendations based on the quality of evidence, balance of benefits and harms, patient preferences, and health economic assessments. This study constructed seven major clinical questions. The main conclusions of this guideline are as follows: 1) Compared with no perioperative allogeneic blood transfusion (NPABT), perioperative allogeneic blood transfusion (PABT) leads to a more unfavorable prognosis in cancer patients (Recommended); 2) Compared with the transfusion of allogeneic blood or no transfusion, IOCS does not lead to a more unfavorable prognosis in cancer patients (Recommended); 3) The implementation of IOCS in cancer patients is economically feasible (Recommended); 4) Leukocyte depletion filters (LDF) should be used when implementing IOCS in cancer patients (Strongly Recommended); 5) Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients (Recommended); 6) A careful assessment of the condition of cancer patients (meeting indications and excluding contraindications) should be conducted before implementing IOCS (Strongly Recommended); 7) Informed consent from cancer patients should be obtained when implementing IOCS, with a thorough pre-assessment of the patient's condition and the likelihood of blood loss, adherence to standardized internally audited management procedures, meeting corresponding conditions, and obtaining corresponding qualifications (Recommended). In brief, current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation, and LDF or irradiation should be used during the implementation process.

Objective:To compare the clinical effects of endoscope-assisted and direct prosthetic augmentation mammaplasty through inframammary fold incisions.Methods:The clinical data of patients who underwent prosthetic augmentation mammaplasty through inframammary fold incisions in Chongqing Huamei Plastic Surgery Hospital from June 2021 to October 2022 were collected. At the same time, the clinical data of patients who underwent the operation under direct vision from June 2015 to May 2021 were collected as control group. The operation time, postoperative drainage tube indwelling time, length of hospital stay and postoperative drainage volume within 1-3 days were recorded in the two groups, and the incision healing, breast morphology and complications were collected. The data were processed by SPSS 26.0 software, which accorded with the measurement data of normal distribution with Mean ± SD, and t-test was used for comparison between the two groups. The data were presented as frequency and (or) percentage, and Fisher’s exact test was used for comparison between the two groups. When P < 0.05, the difference was considered statistically significant. Results:A total of 169 female patients aged 21-48 years old were enrolled, including 71 patients in the endoscope-assisted group and 98 patients in the direct group. There was no significant difference in age, body mass index, prosthesis volume and postoperative follow-up time between the two groups ( P > 0.05). The operation process of the two groups was smooth, and the incisions healed by first intention after the operation. The operation time in the endoscope-assisted group was (123.5±13.5) min, which was slightly longer than that in the direct group [(111.5±8.1) min] ( t=7.20, P<0.001), and the postoperative drainage tube indwelling time[(2.6 ±0.7) d)] was significantly shorter than that in the direct group [(4.2±1.0) d] ( t=-11.58, P < 0.001). The length of hospital stay in the endoscope-assisted group [(2.8±0.8) d] was significantly shorter than that in the direct group [(4.6±1.3) d] ( t=-10.33, P < 0.001). The total amount of bilateral drainage in the endoscope-assisted group was (151.0±30.1) ml on the 1st to 3rd day after the operation, which was significantly lower than that in the direct group[(265.0±48.1) ml ] ( t=-17.62, P < 0.001). During the follow-up for one year, the breast shape and hand feeling of the two groups were good, and there was no infection, prosthesis rupture, displacement or exposure. The patients were satisfied with the results of the operation. The rates of capsular contracture, nipple-areola hypoesthesia and scar hyperplasia in the endoscope-assisted group were 0.7% (1/138), 0.7% (1/138) and 0 (0/138), respectively, which were lower than those in the direct group [2.7%(5/188), 3.7%(7/188) and 2.7%(5/188)], respectively, but the differences were not statistically significant ( P > 0.05). Conclusion:Both endoscope-assisted and direct prosthetic augmentation mammaplasty through an inframammary fold incision can achieve satisfactory results. The operation time of endoscope-assisted augmentation mammaplasty is slightly longer than that under direct vision, but the surgical trauma of that is less, the postoperative drainage tube indwelling time and length of hospital stay are shortened, and the amount of bleeding in the operation area is reduced.

Objective:To compare the clinical effects of endoscope-assisted and direct prosthetic augmentation mammaplasty through inframammary fold incisions.Methods:The clinical data of patients who underwent prosthetic augmentation mammaplasty through inframammary fold incisions in Chongqing Huamei Plastic Surgery Hospital from June 2021 to October 2022 were collected. At the same time, the clinical data of patients who underwent the operation under direct vision from June 2015 to May 2021 were collected as control group. The operation time, postoperative drainage tube indwelling time, length of hospital stay and postoperative drainage volume within 1-3 days were recorded in the two groups, and the incision healing, breast morphology and complications were collected. The data were processed by SPSS 26.0 software, which accorded with the measurement data of normal distribution with Mean ± SD, and t-test was used for comparison between the two groups. The data were presented as frequency and (or) percentage, and Fisher’s exact test was used for comparison between the two groups. When P < 0.05, the difference was considered statistically significant. Results:A total of 169 female patients aged 21-48 years old were enrolled, including 71 patients in the endoscope-assisted group and 98 patients in the direct group. There was no significant difference in age, body mass index, prosthesis volume and postoperative follow-up time between the two groups ( P > 0.05). The operation process of the two groups was smooth, and the incisions healed by first intention after the operation. The operation time in the endoscope-assisted group was (123.5±13.5) min, which was slightly longer than that in the direct group [(111.5±8.1) min] ( t=7.20, P<0.001), and the postoperative drainage tube indwelling time[(2.6 ±0.7) d)] was significantly shorter than that in the direct group [(4.2±1.0) d] ( t=-11.58, P < 0.001). The length of hospital stay in the endoscope-assisted group [(2.8±0.8) d] was significantly shorter than that in the direct group [(4.6±1.3) d] ( t=-10.33, P < 0.001). The total amount of bilateral drainage in the endoscope-assisted group was (151.0±30.1) ml on the 1st to 3rd day after the operation, which was significantly lower than that in the direct group[(265.0±48.1) ml ] ( t=-17.62, P < 0.001). During the follow-up for one year, the breast shape and hand feeling of the two groups were good, and there was no infection, prosthesis rupture, displacement or exposure. The patients were satisfied with the results of the operation. The rates of capsular contracture, nipple-areola hypoesthesia and scar hyperplasia in the endoscope-assisted group were 0.7% (1/138), 0.7% (1/138) and 0 (0/138), respectively, which were lower than those in the direct group [2.7%(5/188), 3.7%(7/188) and 2.7%(5/188)], respectively, but the differences were not statistically significant ( P > 0.05). Conclusion:Both endoscope-assisted and direct prosthetic augmentation mammaplasty through an inframammary fold incision can achieve satisfactory results. The operation time of endoscope-assisted augmentation mammaplasty is slightly longer than that under direct vision, but the surgical trauma of that is less, the postoperative drainage tube indwelling time and length of hospital stay are shortened, and the amount of bleeding in the operation area is reduced.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

This study retrospectively analyzed the clinical data of four patients with malignant tumor-induced ureteral strictures admitted to our hospital. All patients successfully underwent ureteroscopic metal stent placement surgery under real-time ultrasound guidance, with a surgical duration of (64±33) minutes. Postoperatively, there was a creatinine decrease of (74±127) mmol/L. Only two cases experienced Clavien-Dindo grade I complications postoperatively. The stents were well positioned in all patients, with a postoperative hospital stay of (2.5±0.6) days. This surgical approach for malignant tumor-induced ureteral obstruction can compensate for the limitations of endoscopic visualization.

Objective To study a safe means of mandibular angle plasty of bone cutting and its clinical efficay.Methods Through grinding bone oblique trapezoidal incisure,mandibular angle wide deformity was then corrected according to the cutting trace on bone cutting method.Results Of 260 cases of torture beauty,185 cases were followed-up,in which 181 (97.84％) cases were satisfied with the results,and 1 case got satisfaction after facial liposuction; other 1 case did not accepted further treatment advice of bone cutting processing because her mandibular angle was too wide.Two cases of bone wax reaction occured and got satisfaction after treatment.Conclusions Mandibular angle plasty by combined grinding with cutting makes it easy for positioning and bone cutting; bone cutting arc becomes more fluent with good exposure of its posterior horn.It can prevent mandibular fracture induced by bone cutting that does not reach the designated position.Therefore,this procedure is relatively simple and safe.

Multidrug resistance (MDR) is one of the main causes leading to the failure in cancer treatment. Differential proteins between esophageal squamous cell carcinoma (ESCC) cell line EC9706 and its cisdiamminedichloroplatinum (CDDP)-resistant subline EC9706/CDDP revealed by quantitative analysis may provide deeper insights into the molecular mechanisms of MDR implicated in ESCC. EC9706/CDDP was generated by exposure of its parental sensitive EC9706 to a step-wise increase of CDDP concentration during EC9706 cultivation. The stable isotope labeling with amino acids in cell culture (SILAC) was used to label EC9706 and EC9706/CDDP with heavy and light medium, separately. Mixed peptides derived from EC9706 and EC9706/CDDP were analyzed by high performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS/MS) and subsequently subjected to bioinformatics analysis to identify differential proteins between EC9706 and EC9706/CDDP. Compared to parental EC9706, EC9706/CDDP manifested phenotypes of slow proliferation, cell pleomorphology, atypia and increased resistant-index 3.23. Seventy-four differential proteins identified in the present study belongs to various families with multiple functions, such as cytoskeleton (20%), energy metabolism (11%), transcription regulation and DNA repair (11%), redox homeostasis (9.5%), protein biosynthesis and mRNA processing (12%), ribosome constituent (8.1%), molecular chaperone (8.1%), immunity/inflammation (5.4%), intracellular transport (5.4%) and nucleosome assembly (2.7%), which indicated that development of MDR is a complicated process involving dysregulation of multiple molecules and pathways. The data is of great value for in-depth elucidation of molecular mechanisms of the MDR implicated in ESCC and may represent potential molecular targets for future therapeutic development.

Objective To compare the efficacy of different rehabilitation models on acalculia after acquired brain injury. Methods 113 cases were randomly assigned to 3 groups: control group(n=37), computer-assisted training group(n=38) and face-to-face training group(n=38). The control group just received cognitive dysfunction evaluation. The training groups received cognitive rehabilitation training 5 days a week and 30 minutes a day which sustained for 6 weeks. And 33 patients were selected to prolong for 12 weeks. They were evaluated with Revised EC301Calculation and Number Processing Battery in Chinese version (EC301-CR) at the beginning, the 6th week point and the 12th week point respectively. Results 6-week after treatment, The performance of both the computer-assisted training group and face-to-face training group significantly improved(P<0.001); It showed that computer-assisted group>face-to-face group>control group(P<0.001) both 6 weeks and 12 weeks latter. Significant negative correlation was found between age and performance of EC301-CR(P<0.05).Conclusion The effect of computer-assisted training on acalculia is superior to face-to-face training; The first 6 weeks of training is the best period for rehabilitation; The younger the patient is, the better results are.

Objective To investigate the possibility of performing epicanthoplasty with same stage small incision blepharoplasty. Methods At the same stage of designing small incision blepharo-plasty, modified "Z" plasty without flap transposition was designed. The upper lid incisive line of epi-canthoplasty was bided in the double eyelid fold, while the lower eyelid incision located at the edge of eyelid. Results A series of 56 patients were treated with this method. Satisfactory esthctical result of double eyelid fold and inner canthus shape was achieved. Conclusion This modified method including epicanthoplasty combined with same stage small incision blepharoplasty has the advantages of minimal scar formation, easy to design perform and in accordance with physiology.

OBJECTIVETo investigate the technique for unilateral cleft lip nasal deformities.

METHODSThrough the traditional columella margin incision, the alar cartilage and the lateral nasal cartilage were exposed. After the mucosa between the two cartilages was divided, a mucosa-cartilage flap was developed and anchored, moving the lateral crus upwardly and medially, correcting the nasal deformity.

RESULTS52 cases of primary nasal deformities and 18 cases of secondary nasal deformities were corrected with this technique. Satisfactory results were achieved.

CONCLUSIONThis technique is recommendable, which is more likely to restore the physiological characters of the nose than the conventional technique.

Adolescent ; Adult ; Child ; Child, Preschool ; Cleft Lip ; surgery ; Humans ; Infant ; Rhinoplasty ; methods