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.

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.

Humans ; Angina, Stable ; COVID-19 ; Risk Factors ; Patients

Objective:To explore the clinical outcome of bilobed free peroneal artery perforator flap to repair the postoperative defect of maxillofacial malignant tumors.Methods:A total of 47 patients with maxillofacial malignant tumor with postoperative defects in the Affiliated Hospital of Nantong University from January 2018 to December 2021 were included. They were treated with bilobed free peroneal artery perforator skin flap. After the tumor was removed, the left leg was used as donor site. Based on the defect area of maxillofacial region, a bilobed perforator flap was designed and harvested. After surgery, the survival of the flap, recovery of voice, swallowing function, and flap appearance were evaluated. Speech and swallowing function were scored on a scale of 10.Results:A total of 47 patients were included, 27 males and 20 females, aged 43-79 years.There were 19 cases of buccal malignant tumors, 19 cases of tongue malignant tumors, 9 cases of gingival malignant tumors, 40 cases of squamous-cell carcinoma, 5 cases of adenoid cystic carcinoma and 2 cases of mucoepidermoid carcinoma. The area of maxillofacial defects ranges from (54-84) cm 2, the area of the flap ranges from (50-81) cm 2. During the operation, 17 cases were repaired and the mandibular was reconstructed with vascularized fibula flap. All 47 patients were followed up for an average of 12 months. All patients’ postoperative defects were effectively covered, the flaps survived, the appearance was satisfactory, the flap donor area is well restored, and the speech and swallowing functions were good. The scores of speech function and swallowing function were (8.15±1.35) and (7.43±1.19) respectively. Conclusions:The bilobed free peroneal artery perforator skin flap can be applied to repair the defects of maxillofacial malignant tumors. The flap appearance is acceptable, the recovery time is short. The defective skeletal tissue can be repaired at the same time. with concealed the donor site.

Objective:To explore the clinical outcome of bilobed free peroneal artery perforator flap to repair the postoperative defect of maxillofacial malignant tumors.Methods:A total of 47 patients with maxillofacial malignant tumor with postoperative defects in the Affiliated Hospital of Nantong University from January 2018 to December 2021 were included. They were treated with bilobed free peroneal artery perforator skin flap. After the tumor was removed, the left leg was used as donor site. Based on the defect area of maxillofacial region, a bilobed perforator flap was designed and harvested. After surgery, the survival of the flap, recovery of voice, swallowing function, and flap appearance were evaluated. Speech and swallowing function were scored on a scale of 10.Results:A total of 47 patients were included, 27 males and 20 females, aged 43-79 years.There were 19 cases of buccal malignant tumors, 19 cases of tongue malignant tumors, 9 cases of gingival malignant tumors, 40 cases of squamous-cell carcinoma, 5 cases of adenoid cystic carcinoma and 2 cases of mucoepidermoid carcinoma. The area of maxillofacial defects ranges from (54-84) cm 2, the area of the flap ranges from (50-81) cm 2. During the operation, 17 cases were repaired and the mandibular was reconstructed with vascularized fibula flap. All 47 patients were followed up for an average of 12 months. All patients’ postoperative defects were effectively covered, the flaps survived, the appearance was satisfactory, the flap donor area is well restored, and the speech and swallowing functions were good. The scores of speech function and swallowing function were (8.15±1.35) and (7.43±1.19) respectively. Conclusions:The bilobed free peroneal artery perforator skin flap can be applied to repair the defects of maxillofacial malignant tumors. The flap appearance is acceptable, the recovery time is short. The defective skeletal tissue can be repaired at the same time. with concealed the donor site.

Objective:To investigate the clinical efficacy of superior hypogastric nerve block (SHNB) in relieving pelvic pain after uterine artery embolization (UAE).Methods:Totally 50 patients of UAE before the curettage of uterine incision pregnancy were selected in Affiliated Zhenjiang Fourth People′s Hospital,Jiangsu University from February 2019 to December 2020 and were randomly divided into SHNB group( n=22) and control group( n=28) using random number table. The SHNB group underwent fluoroscopy-guided SHNB before UAE, and the control group received dizocine 10 mg intramuscularly before embolization. Both groups were treated with curettage 24 h after UAE. The pain scores were evaluated by using a numerical rating scale (NRS) to compare the pain scores between the two groups atthe time period A1 (from the beginning of UAE to immediate postoperative period) and at the time period A2 (from leaving the interventional operating room to the time before curettage). Data was recorded and compared between the two groups at the time period from the beginning of UAE surgery to the time before curettage for the doses of opioids used.The differences inage and weight between the two groups were compared by independent sample t test, and the NRS score and morphine dose were compared by Mann-whitney U test. Results:All patients completed SHNB and UAE without serious complications.There was no significant difference in age and weight between the two groups ( P>0.05).The maximum pain scores in the SHNB group were lower than those in the control group at both the A1 and A2 time periods[0(0, 0.25) vs. 3.00 (2.00, 4.00), and 2.50 (0.75, 5.50) vs. 4.00 (3.25, 7.00); Z=-4.932, -2.351, P<0.05]. The equivalent dose of morphine required in the SHNB group was lower than that of the control group [0(0, 10.00) vs. 10.00 (5.00, 15.00)mg, Z=-2.247, P=0.025]. Conclusion:Fluoroscopic-guided SHNB is a safe, effective, and minimally invasive way to reduce pain and the opiate dose after UAE.

Objective: To report an investigation of a family cluster of coronavirus disease 2019 ( COVID-19 ) in Ningbo, so as to provide reference for the prevention and control measures. Methods: According to the COVID-19 Prevention and Control Program ( fourth version ) , an epidemiological investigation was conducted to collect the demographic information, clinical features and exposure history, to find the close contacts, and to figure out the source and route of infection. Results: Twelve confirmed cases and one asymptomatic case were reported. The attack rate was 16.05%. Among them, five were males and eight were females; the age ranged from 11 to 85 years old, with a median of 39 years old; most had mild symptoms. The incubation period was 2-13 days, with a median of 6.5 days. The first case ( Case 1 ) developed the symptoms on January 22, and had close contact with Zhang, an asymptomatic case, on January 20. Zhang was related to a cluster in the Buddhist assembly on January 19. Case 1, who caused the spread of the epidemic among family members, participated in several family visits and dinners from January 22 to 27 with other 24 families, resulting in six secondary cases and six third-generation cases. There were 54 close contacts except the family members, no infection was found. Conclusion This family cluster may result from the close contact with an asymptomatic case, and then spread within families through having dinners and living together.

Objective To investigate the role of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC1α) in high-fat diet-induced insulin resistance (IR) and mitochondrial degeneration in skeletal muscle.Methods Wistar rats were randomly divided into a normal chow (NC)group (n =10) and a high-fat diet(HFD)group (n =10).After eight weeks,fasting plasma glucose(FBG) levels,fasting insulin(FINS) levels and glucose infusion rates (GIR) in each group were measured (n=3).Samples of rat skeletal muscle were harvested.L6 myoblasts were divided into a control group,a PA group (cells were cultured in palmitic acid),a pcDNA3 group (cells were transfected by the plasmid pcDNA3)and a pcDNA3-PGC1α group (cells were transfected by the PGC1α-overexpressiorn plasmid).Expression levels of PGC1α,nuclear respiratory factor 1 (NRF1),uncoupling protein 3 (UCP3),and cytochrome C oxidase 1 (COX1) in skeletal muscle and L6 myoblasts were measured by real-time PCR and Western blotting.Results Levels of FBG and insulin were higher and those of GIR were lower in the HFD group than in the NC group,(6.0±0.7)mmol/L vs.(5.0±0.4)mmol/L、(23.3±3.0)mU/L vs.(12.9±1.8)mU/L、(14.2±1.8)％ vs.(22.6±2.4)％ (t =-3.578,-6.679,6.265,respectively,P ＜ 0.05).Expression levels of PGC1α,NRF1,UCP3,and COX1 were down in skeletal muscle in the HFD group compared with those in the NC group(P ＜0.05).In L6 myoblasts cultured with palmitic acid,the expression of PGC1 α,NRF1,UCP3,and COX1 were down compared with their expression in the NC group (P ＜ 0.05).However,the altered expression of PGC1α,NRF1,UCP3,and COX1 was reversed by transfecting with PGC1α-overexpression plasmids (F =30.079,96.883,226.772,respectively,P ＜ 0.001).Conclusions High-fat diets can lead to insulin resistance and decreased expression of mitochondrial energy metabolism-related genes,which can be reversed by PGC1α.The decreased expression of PGC1α may mediate the high-fat diet-induced mitochondrial dysfunction and IR.

Objective: To compare and analyze the effects of forearm flap and superior trapezius myocutaneous flap in repairing oral cancer defects. Methods: 56 cases of defect repair after oral cancer radical surgery were treated with the forearm flap (29 cases) and superior trapezius myocutaneous flap (27 cases). The success rate, postoperative quality of life and postoperative recovery time of the two groups were compared. The t-test was used for statistical analysis. Results: The success rate of forearm flap group was 96.6%(28/29) compared to 96.3%(26/27) in the trapezius myocutaneous flap group (P=0.920). The postoperative recovery time was (9.4±2.7) d (forearm flap group) and (9.3±2.6) d (trapezius myocutaneous flap group), respectively (P=0.489). The score of postoperative quality of life was 576.3±76.2 (forearm flap group) and 568.4±79.3 (trapezius myocutaneous flap group), respectively (P=0.471). There was no significant difference in all comparisons (P>0.05). Conclusions The free forearm flap and the superior trapezius myocutaneous flap pedicled with the transverse cervical artery can be used to repair the oral cancer, and satisfactory function and ideal clinical effect can be achieved. Both two kinds of flaps have high success rate and good clinical practical value. The latter has little influence on the donor site, and can be used as the first choice.

PURPOSE: Caffeine is the most widely consumed psychostimulant. It is often adopted as a tool to modulate brain activations in fMRI studies. However, its pharmaceutical effect on task-induced deactivation has not been fully examined in fMRI. Therefore, the purpose of this study was to examine the effect of caffeine on both activation and deactivation under sustained attention. MATERIALS AND METHODS: Task fMRI was acquired from 26 caffeine naive healthy volunteers before and after taking caffeine pill (200 mg). RESULTS: Statistical analysis showed an increase in cognition-load dependent task activation but a decrease in load dependent de-activation after caffeine ingestion. Increase of attention and memory task activation and its load-dependence suggest a beneficial effect of caffeine on the brain even though it has no overt behavior improvement. The reduction of deactivation by caffeine and its load-dependence indicate reduced facilitation from task-negative networks. CONCLUSION: Caffeine affects brain activity in a load-dependent manner accompanied by a disassociation between task-positive network and task-negative network.
Brain ; Caffeine* ; Eating* ; Healthy Volunteers ; Magnetic Resonance Imaging ; Memory ; Memory, Short-Term*