Objective:To investigate the efficacy of V-Y advancement flap with facial artery perforator for the repair of midface skin defects.Methods:A retrospective analysis was performed on 18 patients with facial skin cancer, including 11 males and 7 females, aged 65-83 years, who underwent the repair of midface skin defects using V-Y advancement flap with facial artery perforator in the Department of Head and Neck Surgery, Affiliated Cancer Hospital of Nantong University from January 2020 to April 2023. Medium, large or complex midface skin defects developed after surgical resections of the primary lesions. According to the defect site, size, location information of facial vessels, a V-Y advancement flap with appropriate shape was designed for each case. During the operation, the facial vessels and their perforators were retained in the pedicle of the flap, the facial nerve branches were dissected and protected, and the further denuded pedicle was determined according to actual amount of advancement. After the flap was advanced, the facial defect area was repaired without tension, and the anatomical positions and functions of the eyes, nose and mouth were restored as far as possible. Postoperative follow-ups were conducted to observe the survival rate of the flaps, postoperative complications, recurrences and metastases of tumors.Results:Midface defects of 3.0 cm×3.5 cm-6.5 cm×7.5 cm were observed after tumor resections, which involved one or more subregions. The sizes of the flaps were 3.5 cm×9.0 cm-7.0 cm×18.0 cm. All flaps were completely alive except for one with temporary local bruising. With following-up of 4-40 months, 5 of the 12 patients with lower eyelid and inner canthus invasions had lower eyelid ectropion, but no exposed keratitis was found; one case with poorly differentiated squamous cell carcinoma had lymph node metastasis in the submandibular region and underwent neck dissection again; no recurrence or metastasis occurred in the remaining cases.Conclusion:The V-Y advancement flap with facial artery perforator can be used to repair medium, large or complex midface skin defects, with a high survival rate, and the operation method is safe and reliable.

Surgical treatment for bone and soft tumors of pelvis and sacrum presents a big challenge, because of the complex anatomy of sacropelvic region, large tumor volume at presentation, rich blood supply to the tumor and visceral involvemen, et al. Therefore, surgical excision and reconstruction are technically difficult for sacropelvic tumors. Extensive intraoperative haemorrhage could be life-threatening, and this issue remains a major concern. How to effectively control bleeding during surgery is critical for successful operation and patient's favorable prognosis. Some previous attempts, such as interventional selective internal iliac artery embolization or manual ligation through an additional anterior approach, were tested to be ineffective. Inspired by the success of resuscitative endovascular balloon occlusion of the aorta (REBOA) which resemble an endovascular tourniquet for traumatic hemorrhagic shock, some researchers have applied this techinique to control surgical bleeding during pelvic or sacral tumor resection.The authors have performed REBOA for more than 1 500 sacropelvic tumr surgeries since 2003 in Peking University People's Hospital. The patient age, the diameter of femoral artery and aorta, atherosclerosis, as well as tumor location, volume and expansion and blood suppy, have to be thoroughly evaluated prior to REBOA administration. Admittedly, the application of REBOA do reduce intraoperative bleeding, shorten the operation duration, improve the safety of surgery, yet some complications were observed including local hematoma at the puncture site, acute arterial thrombosis, femoral artery pseudoaneurysm or occlusio, et al. The purpose of this study is to review the literature on REBOA administration in pelvic and sacral tumors excision, with the focus on its indications, performing procedure, the safety and efficacy, and complications. Moreover, in order to popularize the clinical application of aortic balloon occlusion in the future, we summarize our experience of abdominal aortic balloon occlusion over 10 years.

Objective:To investigate the causes,prevention and treatment of femoral artery puncture related complications caused by the application of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the resection of pelvic and sacral tumors.Methods:Clinical data of 23 patients with femoral artery puncture related complications who received REBOA in the resection of pelvic and sacral tumors from August 2010 to August 2018 at the Musculoskeletal Tumor Center,Peking University People′s Hospital were retrospectively analyzed.There were 8 males and 15 females,with the age of (37.0±16.2) years (range:15 to 65 years).Arterial access via the Seldinger technique for REBOA was obtained in the right common femoral artery of 18 cases,and in the left of 6 cases.An arterial sheath with a diameter of 11 to 12 F(1 F≈0.33 mm) was used for the patient.The occurrence and treatment of postoperative complications were analyzed.Results:Acute femoral arterial thrombosis occurred in 18 patients,which was managed by open repair 48 hours postoperatively.Among the 349 patients admitted before 2015 who received hemostasis by compression after femoral artery sheath removal,12 patients (3.4%) developed acute femoral artery thrombosis.While the 476 patients admitted after 2015 who used a percutaneous suture device to close the femoral artery wound,6 patients (1.3%) developed acute femoral artery thrombosis.One case of retroperitoneal hematoma and 1 case of femoral pseudoaneurysm were found and surgically fixed.Postoperative follow-up was (40±18) months (range:13 to 108 months).Three cases with chronic lower extremity ischemia were confirmed by Doppler ultrasonography during 1 to 5 years follow-up.Two of them had minimal symptoms and denied further treatment,while the other one received femoral-femoral artery bypass surgery to restore distal flow for pain and numbness relief.Conclusions:Acute femoral arterial thrombosis is the most common femoral artery puncture.Technique refinement of REBOA,the use of percutaneous suture device and close follow-up can reduce the approach-specific complications,and help to detect and treat the complications timely,which may popularize the clinical application of REBOA.

Objective:To investigate the causes,prevention and treatment of femoral artery puncture related complications caused by the application of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the resection of pelvic and sacral tumors.Methods:Clinical data of 23 patients with femoral artery puncture related complications who received REBOA in the resection of pelvic and sacral tumors from August 2010 to August 2018 at the Musculoskeletal Tumor Center,Peking University People′s Hospital were retrospectively analyzed.There were 8 males and 15 females,with the age of (37.0±16.2) years (range:15 to 65 years).Arterial access via the Seldinger technique for REBOA was obtained in the right common femoral artery of 18 cases,and in the left of 6 cases.An arterial sheath with a diameter of 11 to 12 F(1 F≈0.33 mm) was used for the patient.The occurrence and treatment of postoperative complications were analyzed.Results:Acute femoral arterial thrombosis occurred in 18 patients,which was managed by open repair 48 hours postoperatively.Among the 349 patients admitted before 2015 who received hemostasis by compression after femoral artery sheath removal,12 patients (3.4%) developed acute femoral artery thrombosis.While the 476 patients admitted after 2015 who used a percutaneous suture device to close the femoral artery wound,6 patients (1.3%) developed acute femoral artery thrombosis.One case of retroperitoneal hematoma and 1 case of femoral pseudoaneurysm were found and surgically fixed.Postoperative follow-up was (40±18) months (range:13 to 108 months).Three cases with chronic lower extremity ischemia were confirmed by Doppler ultrasonography during 1 to 5 years follow-up.Two of them had minimal symptoms and denied further treatment,while the other one received femoral-femoral artery bypass surgery to restore distal flow for pain and numbness relief.Conclusions:Acute femoral arterial thrombosis is the most common femoral artery puncture.Technique refinement of REBOA,the use of percutaneous suture device and close follow-up can reduce the approach-specific complications,and help to detect and treat the complications timely,which may popularize the clinical application of REBOA.

The objective was to investigate the effect of kinsenoside (Kin) treatments on macrophage polarity and evaluate the resulting protection of chondrocytes to attenuate osteoarthritis (OA) progression. RAW264.7 macrophages were polarized to M1/M2 subtypes then administered with different concentrations of Kin. The polarization transitions were evaluated with quantitative real-time polymerase chain reaction (qRT-PCR), confocal observation and flow cytometry analysis. The mechanism of Kin repolarizing M1 macrophages was evaluated by Western blot. Further, macrophage conditioned medium (CM) and IL-1 were administered to chondrocytes. Micro-CT scanning and histological observations were conducted on anterior cruciate ligament transection (ACLT) mice with or without Kin treatment. We found that Kin repolarized M1 macrophages to the M2 phenotype. Mechanistically, Kin inhibited the phosphorylation of IB, which further reduced the downstream phosphorylation of P65 in nuclear factor-B (NF-B) signaling. Moreover, Kin inhibited mitogen-activated protein kinases (MAPK) signaling molecules p-JNK, p-ERK and p-P38. Additionally, Kin attenuated macrophage CM and IL-1-induced chondrocyte damage. , Kin reduced the infiltration of M1 macrophages, promoted M2 macrophages in the synovium, inhibited subchondral bone destruction and reduced articular cartilage damage induced by ACLT. All the results indicated that Kin is an effective therapeutic candidate for OA treatment.

Due to individual differences of the depth of anaesthesia (DOA) controlled objects, the drawbacks of monitoring index, the traditional PID controller of anesthesia depth could not meet the demands of nonlinear control. However, the adjustments of the rules of DOA fuzzy control often rely on personal experience and, therefore, it could not achieve the satisfactory control effects. The present research established a fuzzy closed-loop control system which takes the cerebral state index (CSI) value as a feedback controlled variable, and it also adopts the particle swarm optimization (PSO) to optimize the fuzzy control rule and membership functions between the change of CSI and propofol infusion rate. The system sets the CSI targets at 40 and 30 through the system simulation, and it also adds some Gaussian noise to imitate clinical disturbance. Experimental results indicated that this system could reach the set CSI point accurately, rapidly and stably, with no obvious perturbation in the presence of noise. The fuzzy controller based on CSI which has been optimized by PSO has better stability and robustness in the DOA closed loop control system.
Anesthesia ; methods ; Anesthesiology ; methods ; Anesthetics, Intravenous ; administration & dosage ; Feedback ; Fuzzy Logic ; Propofol ; administration & dosage

This paper provides a brief overview of the current research activities which focused on the bio-application of gold magnetic nanocomposite particles. By combining the magnetic characteristics of the iron oxide core with the unique features of nano-gold particles such as targeting by surface modification and optical properties, such composite nanoparticles have a wide range of applications in cancer hyperthermia, CT and MRI imaging, bio-separation, bio sensors, gene diagnosis, drug targeting and many other biomedical fields.
Diagnostic Imaging ; Drug Delivery Systems ; Ferric Compounds ; chemistry ; Gold ; chemistry ; Humans ; Magnetics ; Nanocomposites ; chemistry ; Nanoparticles ; chemistry ; Neoplasms

CpG motifs are unmethylated oligodeoxynucleotides,and its core sequences are composed of unmethylated cytosine and unmethylated guanine.CpG motifs can induce the immune response by activating a variety of immune cells against diseases.The changes of CpG structure will increase the biological activities of CpG,and then enhance the therapeutic effect of CpG as the immuno adjuvant and the sensitizer of radiotherapy and chemotherapy in cancer treatment

Noninvasive detection of tissue lesion is an important aided way in the process of high intensity focused ultrasound (HIFU) treatment. A new method is proposed for noninvasive detection of tissue lesion based on self-organizing maps (SOM) network. Tissue lesion, created by HIFU exposures, inevitably leads to change in B-mode image, since some new interfaces will appear in tissue. The difference-sub-image near focus of HIFU, where the tissue lesion appears, is used. Feature of lesion in difference-sub-image is extracted using the method based on SOM network. Experimental results show that the performance of the method proposed in this paper is better than that of others, such as the methods based on average gray, energy and standard deviation of difference-sub-image.
High-Intensity Focused Ultrasound Ablation ; adverse effects ; instrumentation ; Humans ; Neoplasms ; therapy ; Neural Networks (Computer) ; Signal Processing, Computer-Assisted

OBJECTIVE: To investigate dosimetric characteristics and to evaluate the clinical efficacy of intensity modulated radiotherapy (IMRT) as compared with conventional radiotherapy in nasopharyngeal carcinoma (NPC). METHODS: Forty-seven NPC patients who accepted IMRT served as the IMRT group, and conventional radiotherapy plan was also made for each patient in this group using the treatment planning system. Dosiological evaluation of the 2 radiotherapy plans was made through dose volume histogram, 95% target volume dose (V(95)) and normal tissue complication probability. Another 47 patients who underwent conventional radiotherapy (CRT) at the same period formed the control group. The therapeutic effect as well as the acutes and late toxicities of normal tissues in the 2 groups were observed. RESULTS: V(95) of the IMRT was more than 96% (96.83%-99.99%) for each target area, obviously superior to CRT in the sub-clinical target area. The radiation dose of normal tissues such as the brainstem and the spinal cord in the IMRT was much less than that in the CRT. Consistant with this, the part and complete remission rate, the 3-year loco-regional progress free survival rate, and overall survival rate in the IMRT group were all higher than those in the CRT group. For most patients in the IMRT group, the grade of acute toxicities was much lower than that in the CRT group. Patients in the IMRT group showed no more than grade 3 xerostomia, while in the CRT group still 21% of the patients suffered grade 3 or higher xerostomia a year later. CONCLUSION Compared with CRT, IMRT can improve the target volume dose and decrease the dose of surrounding tissues, resulting in higher control rate and fewer side effects.
Adult ; Carcinoma, Squamous Cell ; radiotherapy ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Young Adult