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Objective To explore the expression of triggering receptor expressed on myeloid cells 2(TREM2)in high-glucose microglia and to investigate the role of TREM2 in the proliferation,migration and phagocytosis of high-glucose microglia.Methods Microglia cells were divided into control group and high-glucose treatment group(67.5 mmol/L glucose,24 h).The microglia cells were counted and the expression of Iba1 and TREM2 was de-tected.TREM2 siRNA was transfected to detect the proliferation and migration of microglia.The amyloid β-peptide(Aβ)with a fluorescent tag was added to observe the phagocytosis of Aβ by microglia.Results Compared to normal microglia,the number of microglia significantly decreased after high-glucose treatment(P＜0.001),while the ex-pression of TREM2 and Iba1 markedly increased(P＜0.001).High glucose and TREM2 did not affect the prolifer-ation of microglia.Compared to the normal group,the migration of microglia significantly decreased after high-glu-cose treatment(P＜0.05)and TREM2 did not affect the migration ability of high-glucose microglia.Compared to the normal group,the phagocytosis of Aβ by microglia significantly decreased in the high-glucose treated group(P＜0.001).Furthermore,TREM2 knockdown further decreased the phagocytosis of Aβ by high-glucose microglia(P＜0.001).Conclusions The expression of TREM2 in microglia significantly increases after high-glucose treat-ment,which significantly affects phagocytosis of Aβ by microglia.
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Objective To analyze the clinical features and surgical treatment strategies of T4a thyroid cancer.Methods We retrospectively analyzed patients with thyroid cancer treated in the Department of Head and Neck Surgery of Sichuan Cancer Hospital from January 2004 to May 2021.A total of 303 cases were included and statistically analyzed for pathological type,invaded organs,surgical approach,survival time,and overall survival rate.The postoperative survival curves of the patients were analyzed using the Kaplan Meier method.Results Of the 303 patients enrolled,53 patients were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 98.4％(246/250),97.0％(224/231)and 90.2％(92/102),respectively.Of the 94 patients with recurrent laryngeal nerve invasion only,13 were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 100％(81/81),98.7％(77/78)and 97.4％(38/39),respectively.There were 151 patients with invasion of recurrent laryngeal nerve and tracheal/laryngeal/esophageal nerve,31 of them were lost to follow-up,and the 1-year,3-year and 5-year overall survival rates were 96.7％(116/120),95.3％(101/106)and 82.2％(37/45),respectively.According to the survival curve analysis,the group with recurrent laryngeal nerve invasion only had an advantage in overall survival time over the group with recurrent laryngeal nerve and tracheal/laryngeal/esophageal invasion.Conclusion Surgical resection is supposed to be preferred for T4a thyroid cancer if there is a chance of surgery.A reasonable surgical strategy,radical surgery while preserving the vital tissues and organs,and one-stage repair and reconstruction can bring patients a better quality of life and prognosis.
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【Objective】 To measure and analyze foot development indicators of children under 3 years old, in order to provide basis for the correct clinical assessment of children foot development. 【Methods】 A total of 5 894 children under 3 years old who took physical examination in the Child Health Care Department of Xi′an People′s Hospital from August 2022 to March 2023 were randomly selected. Foot length, foot width, the ratio of foot width to length and arch index were measured by image processing system, and were compared among different age groups and sex groups. 【Results】 1) Foot length, foot width and arch index of children under 3 years old increased significantly with age, while the ratio of foot width to length decreased significantly with age(F=1 345.23, 396.21,184.65, 287.03, P<0.05). 2) There was no statistical significance in foot length, foot width and arch index between left and right foot of children under 3 years old(P>0.05). 3) Foot length and foot width of boys were greater than those of girls in all age groups, and the difference was statistically significant(tfoot length:3.45 - 10.19, tfoot width: 3.77 - 9.21, P<0.05). There was no significant difference in arch index between boys and girls in all age groups(P>0.05). 【Conclusion】 Foot shape of children under 3 years old changes with age, there are differences in foot length and width between boys and girls.
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Objective:To analyze the risk factors of hypoparathyroidism after thyroid cancer surgery.Methods:The clinical data of 430 patients who underwent total thyroidectomy and central lymph node dissection due to thyroid cancer from Jan. 2021 to Dec. 2021 in the First Ward of Head and Neck Surgery of Sichuan Cancer Hospital were collected. They were divided into two groups according to their parathyroid hormone levels at day 1 and 6 months after surgery: temporary hypoparathyroidism group ( n = 174) and permanent hypoparathyroidism group ( n = 11). and patients with normal parathyroid function were selected as control group (256 cases on postoperative day 1 and 419 cases on postoperative month 6). Gender, age, body mass index, tumor diameter, invasion, central lymph node dissection, parathyroid transplantation, Hashimoto’s thyroiditis, and lymph node dissection in lateral neck region were monitored. The suspicious risk factors of hypoparathyroidism were evaluated by χ2 test and multivariate logistic regression analysis. Results:Univariate analysis showed that women (86.21% vs 77.34%, χ2 = 5.73, P = 0.022) and parathyroid autotransplantation (44.83% vs 28.91%, χ2 = 11.49, P = 0.001) were associated with postoperative transient hypoparathyroidism. The posterior capsule of tumor invasion (81.82% vs 45.11%, χ2 = 5.81, P = 0.016) was associated with postoperative hypoparathyroidism.Multivariate analysis showed that the independent risk factors of transient hypoparathyroidism were female ( P=0.028, OR=1.870), the largest diameter of tumor ( P=0.043, OR=1.595), extravasation of tumor ( P=0.018, OR=1.587), and parathyroid transplantation ( P=0.001, OR=1.966). The independent risk factor of permanent parathyroidism was the posterior capsule of tumor invasion ( P=0.046, OR=4.658) . Conclusions:Female, the largest tumor diameter, tumor invasion and parathyroid transplantation are independent risk factors for transient hypoparathyroidism after total thyroidectomy. The posterior capsule of tumor invasion is an independent risk factor for permanent hypoparathyroidism after total thyroidectomy.
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Hashimoto’s thyroiditis (HT) is one of the most common autoimmune diseases, and often combined with papillary thyroid carcinoma (PTC) .Thyroglobulin antibody and thyroid peroxidase antibody are used as HT marker antibodies and effective indicators for diagnosis. By activating the corresponding immune response, chronic inflammation of the thyroid gland is caused, which is related to the development of tumors. In this review, we analyze the significance of Tg and TgAb in diagnosis and treatment of HT-PTC to provide evidence for future clinical studies.
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Dyslipidemia is an important risk factor of atherosclerotic cardiovascular disease (ASCVD). Statins delay the occurrence and development of ASCVD, and reduce the risk of cardiovascular events and death. Due to safety concerns, there exist insufficient use of lipid-lowering agents and a high withdrawal rate of the agents in the elderly. To promote the prevention and treatment of ASCVD, this expert consensus is issued and focuses on the management of dyslipidemia of Chinese elderly basing on the clinical evidence of the use of lipid-lowering drugs by the elderly, and the lipid management guidelines and expert consensus recommendations at home and abroad.
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Objective:Taking the research field of pulmonary infection as an example, this study analyzed the core author institutions, research hotspots and burst keywords, and explored the application value of scientific knowledge graph in the first step of scientific research management-optimization of scientific research project selection.Methods:" Pulmonary infection" or " pneumonia" were used as key words in CNKI data base from 2014 to 2020, and medical science was selected as the discipline. Cite Space was used to generate the visual graph to analyze publishing institutions, keyword co-occurrence, topic clustering, and timeline burst keywords.Results:13 169 documents were retrieved, and 4 of the top 5 institutions were in Henan Province. In 2020, " Novel Coronavirus" and " Novel Coronavirus pneumonia" were the new hotspot words. " Chronic obstructive pulmonary disease " , " blood gas index" , " inflammatory factor" , and " vitamin A" were the burst keywords in 2018.Conclusions:Scientific knowledge graph is objective, scientific, and efficient in the development of science. It has certain feasibility in the optimization of project selection in scientific research work, and can also be used as a reference basis for experts to evaluate the project reasonability, so as to ensure objectivity and equity. This study also provides reference for scientific research management strategy, reduces research funding costs, and improves the efficiency and capacity of scientific research management.
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BRAF V600E mutation is a common gene mutation in papillary thyroid carcinoma (PTC) , which is associated with the occurrence, development, and prognosis of PTC. TERT promoter mutations are rare in PTC, but PTC with its mutations is more aggressive and has a worse prognosis. Clinically, a small number of PTC patients have both BRAF V600E mutation and TERT promoter mutations. This article provides a brief overview of the co-mutation of BRAF V600E and TERT promoter and the occurrence and development, clinical diagnosis, surgical strategies, postoperative adjuvant treatment, and prognosis of PTC.
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Objective:To discuss strategies in treatment of poorly differentiated thyroid carcinoma (PDTC) .Methods:Clinical data of 31 cases with PDTC were reviewed retrospectively, who were treated in Department of Head & Neck Surgery, Sichuan Cancer Hospital & Institute by primary surgical resection with or without adjuvant therapy. 27 cases had total thyroidectomy compounded neck dissection or extened total thyroidectomy when trachea or esophagus involved. 4 cases underwent partial resection of tumor. 11 cases were treated with external beam radiotherapy (EBRT) after surgery, 10 cases were treated with postoperative radioiodine, and 8 cases had chemotherapy.Results:The median follow-up time was 18 months (ranged from 3-96 months) . 19 patients died of local recurrence or distant metastasis. Kaplan-Meier analysis and Log-rank analysis was used to compare the differences between groups. Five-year survival was 35.9%. Compared to the cases with partial resection, the cases with surgical disease clearance had longer survival ( P=0.00) . The same statistical difference was found between patients with or without radioiodine ( P=0.017) . The patients treated with radioiodine had longer survival. No statistical differences were found among patients with or without chemotherapy or EBRT. COX regression analysis showed stage of tumor ( P=0.005) , total resection ( P=0.006) and postoperative radioiodine ( P=0.013) were same to predict longer survival. Conclusions:Thorough resection of tumor is the most important therapy for PDTC. Postoperative radioiodine is recommended for patients with high recurrence risk. EBRT is recommended to control local unresectable PDTC.
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Fetal omphalocele is a surgical disease with severe defect of fetal abdominal wall which requires emergency treatment after birth. The incidence rate is 2.1/10000, and the mortality rate is 52% to 67%. The improper handling of omphalocele can cause capsular rupture and intestinal exposure, leading to neonatal fluid loss, hypothermia, intestinal necrosis and other complications. It is the major cause of death in newborns. In this paper, we reviewed the characteristics, delivery mode, delivery time, umbilical cord care, and transferring of omphalocele newborns to provide reference for clinical nursing.
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@#Objective To investigate the expression of protein tyrosine kinase 2 (MFGE8) in patients with ischemic brain injury (IBI) and its regulation on macrophage polarization.Methods ELISA was used to detect the expression of MFGE8 protein in peripheral blood of patients with ischemic stroke and middle cerebral artery occlusion (MCAO) rat models;IF was used to detect the localization and expression of MFGE8 in brain;BV-2 microglia was treated with the culture supernatant of N2a neuronal cells (Mfge8CA) stably transformed with Mfge8.The polarization ratio of macrophages was detected by flow cytometry.Western blot detection Mfge8,αv/β 3-integrin,FAK,NF-κB.ERK1/2,JNK1/2,P38,PI3K,AKT,mTOR protein expression.Results The relative content of MFGE8 in peripheral blood of IBI patients and MCAO model rats was significantly lower than that of the control group (Ctrl,P=0.0446,P=0.0259).MFGE8 was highly co-localized with neuron cell marker (NeuN);the proportion of M1 type (CD45+F4/80+iNOS+Arginase1-) macrophages in the brain tissue of MCAO model was significantly higher than that in the Ctrl (P=0.0004).The proportion of M2 type (CD45+F4/80+iNOS-Arginase1+) macrophages was significantly lower than that of the Ctrl (P<0.0001).The proportion of M1 macrophages of BV-2 microglia after supernatant of N2a (mfge8CA) treatment was significantly lower than that of Wild type (WT,P=0.0230).The proportion of M2 macrophages was significantly higher (P<0.0001).The protein expressions of α v/β3-integrin,FAK,p-P85,P85,p-AKT (Ser473),p-mTOR (Ser2481) and p-mTOR (Ser2488) in BV-2 microglia after supernatant of N2a (mfge8CA) treatment were significantly higher than those in WT group.The expression of p-P65 protein was significantly lower than that in WT group.Conclusion MFGE8 is highly expressed in peripheral blood of patients with IBI.MFGE8 derived from neuronal cells may promote BV-2 microglia M2 macrophages polarization by activating PI3K/AKT/mTOR signals,and inhibit the polarization of M1 macrophages.
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In the past 10 years, digital surgery has been widely used in all aspects of clinical medicine, which has promoted the development of surgical operation to individuation and precision. By analyzing the traditional image data and transforming it into real-time images, surgeons can intuitively discover the scope of the lesion and the anatomical relationship between the lesion and the surrounding tissue through 3D visualization. 3D visualization technology plays an important role in predicting the resectability of tumor, surgical planning, surgical approach and so on. The operation of refractory thyroid tumors involves important blood vessels, trachea, esophagus and other important organs of neck and mediastinum. Adequate preoperative assessment of surgical risk and scope is necessary. This paper reviews the application of digital surgical technique in refractory thyroid tumor surgery, and analyzes the advantages of digital surgical technique used in refractory thyroid surgery.
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Objective:To investigate the clinical characteristics of patients complicated with Hashimoto’s thyroiditis (HT) and papillary thyroid micro-carcinoma (PTMC) and risk factors for central lymph node metastasis (CLNM) by analyzing the clinical data.Methods:Clinical data of 770 patients with PTMC admitted to Head and Neck Surgery Center of Sichuan Cancer Hospital from May. 2015 to Nov. 2017 were retrospectively analyzed, including 250 HT-PTMC patients (observation group) and 520 non-HT-PTMC patients (control group) . There were 197 males and 573 females, with a male to female ratio of 1.00:2.91. Into observation indexes included patient’s age, gender, serum thyroid stimulating hormone (TSH) , thyroglobulin antibody (TG-Ab) , thyroid peroxidase antibody (TPO-Ab) , number of foci, diameter of foci, calcification of foci, location of foci (with or without extra-glandular invasion) , number of nodules (no matter benign or malignant) , and lymph node metastasis in central and lateral cervical regions. SPSS 22.0 software was used for statistical analysis. Normally distributed data were expressed ± s. The difference between observation group and control group was compared by chi-square test of single factor analysis. The risk factors of CLNM of the observation group were analyzed with multivariate Logistic regression, the difference was statistically significant if P<0.05. Results:There were statistically significant differences between the observation group and the control group in age ( P=0.006) , gender ( P<0.001) , TSH ( P<0.001) , TG-Ab ( P<0.001) , TPO-Ab ( P<0.001) , number of nodules ( P=0.016) , and central lymph node ( P<0.001) . Compared with non-HT-PTMC group, HT-PTMC group had a higher proportion of women under 55 years old, and both TG-Ab and TPO-Ab had higher positive rates. Patients with HT-PTMC were more likely to show polynodule changes, but their central lymph node metastasis rate was lower than that of the non-HT-PTMC group. Single-factor analysis showed that the number of cancer foci, calcification of cancer foci, and location of cancer foci were significantly correlated with the CLNM of HT-PTMC patients (all P<0.001) . Multivariate Logistic regression analysis showed that multiple cancer foci ( P<0.001) , invasion and capsule ( P<0.001) , and cancer foci with calcification ( P=0.005) were independent risk factors for CLNM. Conclusions:HT-PTMC is more common in women under 55 years of age, and most of them show multiple nodules in bilateral glandular lobes, often accompanied by elevated serum TSH, TG-Ab and TPO-Ab levels. Meanwhile, the lymph node metastasis rate of HT-PTMC is relatively low, and the prognosis may be relatively good. In HT-PTMC, the risk of multiple carcinoma foci, cancer foci with calcification, cancer foci invasion and the occurrence of CLNM is higher. Preventive central lymph node dissection helps to reduce the occurrence of postoperative cervical lymph node recurrence.
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Autism spectrum disorder (ASD) are kind of developmental behavior disorders with the core symptoms of social communication disorders, stereotyped behavior and narrow interest.Genetic factors play an important role in the incidence of ASD.Ion channels are a pore-forming protein on biofilm.They allow certain types of ions to pass through, and help to establish the voltage difference between cytoplasmic membranes, acting as the basis of neuroelectrophysiology.Ion channel abnormalities are related to many diseases, including ASD.In this paper, several kinds of genes related to ASDs in ion channels were reviewed, and in order to provide new ideas in the pathogenesis.
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Objective:To observe the effect of radiofrequency thermocoagulation (RFTC) combined with pulsed radiofrequency (PRF) therapy on lumbar disc herniation (LDH) and the impacts on serum interleukin-8 (IL-8), CXC chemokine ligand 10 (CXCL10).Methods:From July 2014 to May 2017, 60 patients with LDH were randomly divided into two groups according to the random digital table method, with 30 patients in each group.The combination group was given RFTC combined with PRF therapy, while the PRF group was given single foraminal nerve PRF therapy.The visual analogue scale (VAS), the curative effect score of Japanese Orthopaedic Association (JOA) and Oswestry disability index (ODI) were assessed in the two groups before treatment, 7 days after treatment and 3 months after treatment.The serum levels of IL-8, CXCL10 were determined simultaneously.Results:After treatment, the VAS score and ODI in the two groups were decreased(VAS score: t=12.14, 27.85, all P<0.05; ODI: PRF group t=4.932, 7.414, all P<0.05; combination group t=4.235, 9.706, all P<0.05), and the JOA scores increased(PRF group: t=5.329, 7.576, all P<0.05; combination group: t=5.980, 9.526, all P<0.05). There were statistically significant differences in VAS score, JOA score and ODI between the two groups at 3 months after treatment( t=7.329, 5.719, 2.255, all P<0.05), which of the combination group after treatmentwere superior to the PRF group (all P<0.05). The serum levels of IL-8 in the two groups after treatment were decreased (PRF group: t=3.621, 4.631, all P<0.05; combination group: t=3.393, 5.370, all P<0.05), and the CXCL10 levels in the two groups after treatment were increased(PRF group: t=2.251, 3.559, all P<0.05; combination group: t=3.393, 5.370, all P<0.05). There were statistically significant differences in IL-8, CXCL10 levels between the two groups at 3 months after treatment, and the regulation of IL-8 and CXCL10 levels in the combination group was significantly better than those in the PRF group ( t=20258, 2.237, all P<0.05). Conclusion:RFTC combined with PRF is effective in the treatment of LDH, which can significantly relieve the clinical symptoms, reduce the inflammatory response and has a lasting efficacy.
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Objective:To explore the patterns and causes of occupational exposure to infectious diseases (OEID) among frontline medical staffs (FMS) in coronavirus disease 2019 (COVID-19) isolation wards (CIW), and the particularity of post-OEID management and the measures to prevent OEID.Methods:A total of 1 061 FMS of Wuhan Huoshenshan Hospital from February 4 to March 21, 2020 were enrolled. The OEID of FMS was investigated and analyzed from the perspectives of FMS physical and psychological conditions, protective equipment, infection-control related regulations and procedures, local air quality, exposure patterns, and the particularity of emergency treatment after exposure.Results:The incidence of OEID among FMS was 2.0%(21/1 061). The nurses and doctors accounted for 95.2%(20/21) and 4.8%(1/21), respectively. The incidences in 17 general wards and two intensive care units (ICU) were 71.4%(15/21) and 28.6%(6/21), respectively. Nearly 90.5%(19/21) and 9.5%(2/21) of the OEID events occurred in contaminated area and potential contaminated area, respectively. About 23.8%(5/21) of the OEID events were air exposure of oral-nasal skin, mucosa and respiratory tract, which was secondary to uncontrollable vomiting, and 76.2%(16/21) were pricking injuries. The inducement factors involved poor quality and inappropriate wearing of some goggles, atomization of the inside of goggles leading to blurring vision, chest distress and decreased sense of touch and operational flexibility related to level-3 protection equipment, poor air quality, FMS physical and psychological conditions, etc. Under the direction of "the Procedures for Handling OEID" , all incidents are properly handled and no FMS was infected by 2019 novel coronavirus and blood-borne pathogens. No new OEID event was found after the strict implement of set of preventive measures.Conclusions:The OEID among FMS in CIW is attributed to multiple causes. The optimized process that takes into account the specificity of OEID management for both COVID-19 and blood-borne infectious diseases can effectively prevent potential post-exposure infections. And reasonable precautions can fully reduce the risk of OEID of FMS in CIW.
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Objective:To investigate the effect of Masquelet technique combined with platelet-rich plasma (PRP) on repair of massive tibial defects.Methods:A prospective randomized controlled single blind trial was conducted in the 21 patients who had been admitted to Department of Repair and Reconstruction Surgery, Foshan Hospital of Chinese Medicine for massive tibial defects from June 2016 to June 2018.The length of bone defects ranged from 6.0 to 22.5 cm (mean, 10.8 cm)in length.They were 14 males and 7 females, aged from 29 to 60 years(mean, 42.1 years).The patients were divided into 2 groups by an en-crypting envelope with a random digital table.In the experimental group of 11 cases, the bone defects were repaired with Masquelet technique combined with PRP; in the control group of 10 cases, the bone defects were reconstructed with only Masquelet technique.The 2 groups were compared in terms of operation time, hospital stay, wound healing, weight-bearing time, bony union time, clinical union time, complications and John-er-Wruhs scores at the second stage.Results:The 2 groups were comparable due to insignificant differ-ences between them in the preoperative general data ( P>0.05).All patients were followed up for 12 to 24 months (mean, 14.9 months).There were no significant differences in operation time, hospital stay, wound healing, weight-bearing time, Johner-Wruhs scores or rate of complications at the second stage between the 2 groups ( P>0.05).The bony union time (4.5 months ± 1.2 months) and clinical union time (4.1 months ± 0.9 months) in the experimental group were significantly shorter than those (5.7 months ± 1.5 months and 5.4 months ± 1.1 months) in the control group ( P<0.05).No such postoperative complications as infection, loosening of internal fixator, bone resorption or nonunion were found in the experimental group.One case of wound infection occurred in the control group but responded to dressing change. Conclusion:Masquelet technique combined with PRP is a safe and effective reparative treatment for massive tibial defects and can speed up bone healing.
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Objective:To investigate the expression and its clinical significance of cydooxygenase-2(COX-2)and tumor necrosis factor-alpha(TNF-α)in mucosal tissues in elderly ulcerative colitis(UC)patients with arthritis.Methods:A total of 164 active(observation group)and 50 non-active(control group)UC patients with arthritis were admitted in our hospital from April 2016 to March 2019.Diagnostic criteria of UC and its severity were based on Consensus on the Norms for Diagnosis and Treatment of Inflammatory Bowel Disease in China(2007). The expressions of COX-2 and TNF-alpha in mucosal tissues were detected and compared between the two groups.Patients in the observation group were re-grouped according to the severity of ulcer lesion and Kellgren-Lawrence(K-L)score of arthritis.Based on severity of ulcer lesion and Kellgren-Lawrence(K-L)score of arthritis, the patients in observation group were re-grouped intoⅠ, Ⅱ, Ⅲ, Ⅳ subgroups, among those subgroups the expressions of COX-2 and TNF-alpha in mucosal tissues were compared.Results:The expressions of COX-2 and TNF-alpha in mucosal tissue were higher in the observation group than in the control group( P<0.05), and were increased along with the increased severity of UC and the K-L grade of arthritis( P<0.05). The differences in above expressions had statistical significance among patients with different severity of ulcer and different K-L grade of arthritis.The expressions of COX-2 and TNF-alpha in mucosal tissues were positively correlated with the severity of ulcer( r=0.491 and 0.627, P<0.05 or 0.01)and K-L grade of arthritis( r=0.438 and 0.597, P<0.05 or 0.01). Conclusions:The expressions of COX-2 and TNF-alpha in mucosal tissues are positively correlated with the severity of ulcer and K-L grade of arthritis in elderly UC patients with arthritis.The detection of COX-2 and TNF-alpha levels is helpful to evaluate the disease severity.
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Objective To study the efficacy and safety of radiofrequency ablation combined with splenectomy in treatment of primary liver cancer with liver cirrhosis and hypersplenism.Methods Thirty patients with hepatocellular carcinoma complicated with liver cirrhosis and hypersplenism were treated in Fuyang People's Hospital from January 2016 to December 2017.These patients were randomly divided into the observation group (n =15) and the control group (n =15).Surgical liver resection combined with splenectomy was performed in the control group,and radiofrequency ablation combined with splenectomy was performed in the observation group.The time of thermal ischemia,operation time,intraoperative blood loss,blood transfusion volume,length of hospital stay,platelet level and liver function 1 week after surgery,and the incidences of postoperative complications and the overall survival rates 2 years after surgery were compared between the two groups.Results The operation times of the observation group and the control group were (89.1 ± 18.4 vs.118.9 ± 33.6) rin,blood loss (228.4 ± 120.5 vs.362.2 ± 159.5) ml,blood transfusion (192.3±112.4 vs.503.8±196.2) ml,and length of hospital stay (13.5±6.0 vs.21.9±11.6) d (all P＜0.05).After a week of operation,the indicators in the observation group were significantly better than the control group (all P＜0.05).The postoperative two-years complication rate in the observation group was 13.3％,which was significantly lower than the control group (46.7％,P＜0.05).There was no significant difference in the survival rates between the two groups two years after surgery.Conclusions Radiofrequency ablation combined with splenectomy for treatment of liver cancer with cirrhosis and hypersplenism effectively reduced postoperative complications,preserved liver function,increased platelet levels,improved hypersplenism,and was safer.It is a surgical method worthy of generalization.
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Objective@#To explore the advantages and clinical efficacy of free chimeric perforator flap based on the descending branch of circumflex femoral artery applied to tongue reconstruction after advanced tongue cancer resection.@*Methods@#From October 2013 to December 2018, 57 cases received tongue and oral base reconstruction surgeries using the descending branch of circumflex femoral artery chimeric perforator flap, including 39 males and 18 females, ranged from 20 to 76 years old. And all cases were with stage T3 and T4 tongue cancers, including 35 cases of squamous cell carcinoma, 7 cases of low differentiation cancer, 5 cases of oncosarcoma, and 10 cases of adenoid cystic carcinoma. The tongue was reconstructed by using perforator flap and muscle flap to fill the dead space at the oral floor. The artery anastomoses with the superior thyroid artery or facial artery in the receiving area, and the vein anastomoses with the internal jugular vein in the receiving area. The shape, function and local complications of the reconstructed tongue were observed after operation.@*Results@#Of 57 cases, only one case had partial necrosis of flap, while other 56 cases with chimeric perforator flap survived. Postoperative gastric tube and tracheal cannula were removed in all patients, no cases with oral fistula. All donor sites were sutured in one stage. Postoperative radiotherapy was performed in 41 of the patients. All patients were followed up for 3 to 60 months (average of 20.7 months), with satisfactory esthetic and functional results in reconstructed tongues. Only linear scars were left in the donor areas of the legs, and no lower limb dysfunction was observed.@*Conclusions@#The descending branch of circumflex femoral artery chimeric perforator flap can used for repairing simultaneously the defects of both tongue and oral base. It is helpful to avoid the occurrence of oral fistula and to provide the reconstructed tongue with a good function. It is a good choice to use the descending branch of circumflex femoral artery chimeric perforator flap for tongue reconstruction after resection of advanced tongue cancer resection.