Comparison of two types of flaps based on dorsal cutaneous branch of proper palmar digital artery for repair of wound of fingertip or finger-pulp / 中华显微外科杂志

Objective:To compare the clinical effectiveness of propeller flap and vascular chain flap based on dorsal cutaneous branch of proper palmar digital artery for repair of wounds of fingertip or finger-pulp.Methods:From April 2018 to May 2021, a total of 55 patients (55 fingers) with wounds of fingertip or finger-pulp in the 2nd-5th fingers were treated in emergency surgery in the Department of Hand Surgery, the Second Hospital of Tangshan. The patients were randomly divided into 2 groups by the method of drawing lots. The wounds of 29 patients (29 fingers) were repaired by propeller flaps based on dorsal cutaneous branch of proper palmar digital artery (propeller group) and that of 26 patients(26 fingers) were treated by vascular chain flaps based on dorsal cutaneous branch of proper palmar digital artery(vascular chain group). Survival of the flaps and the skin grafts at donor sites were observed between the 2 groups. The operation and follow-up time in both groups were recorded. Postoperative follow-up included outpatient clinic visits, telephone reviews and WeChat video-clips. At final follow-up, the static TPD of the flaps, patient satisfaction with the appearance of flaps and donor sites and the Range of motion(ROM) of the injured fingers were recorded. The measurement and count data of both groups were compared by independent sample t-test, χ2 tests or Fisher's exact test, respectively. P<0.05 was considered a statistically significant. Results:All the flaps and skin grafts survived primarily in both groups. The operation time in propeller group was 57.55 minutes±4.35 minutes. It was less than what in the vascular chain group (61.12 minutes±4.58 minutes) and with statistically significant difference( P<0.05). The follow-up period was 14.55 months±2.89 months in propeller group and 15.15 months±3.78 months in the vascular chain group. There was no significant difference between the 2 groups( P>0.05). At final follow-up, the static TPD and patient satisfaction with the appearance of flaps in propeller group were 6.55 mm±1.24 mm and 4.59±0.50, which were better than 7.46 mm±1.27 mm and 4.31±0.47 in the vascular chain group with a statistically significant difference( P<0.05). The patient satisfaction with the appearance of donor sites and ROM of the injured digital joints in propeller group were 4.45±0.57 and 190.86°±8.56°, while what in the vascular chain group were 4.35±0.56 and 185.96°±10.58°. There was no significant difference between the 2 groups( P>0.05). Conclusion:The propeller flap and vascular chain flap are both based on dorsal cutaneous branch of proper palmar digital artery and are both suitable for repair of wounds of fingertip or finger-pulp. Compared with the vascular chain flap, the propeller flap has the advantages in shorter operation time, better flap sensation and appearance.

Application of distance education in radiological health continuing education and training / 中国辐射卫生

The implementation of distance education in radiological health continuing education and training was analyzed to provide a reference for improving the quality of radiological health continuing education. The significance, measures, and advantages revealed that the application of distance education in radiological health continuing education and training was conductive to improving the quality of training and fulfilled the needs of radiological health technicians for high-quality training resources. In the future, we will continue to implement and improve distance education, promoting the high-quality development of radiological health continuing education and training.

Analysis of national quality control testing training on radiodiagnostic and radiotherapy equipment from 2018 to 2022 / 中国辐射卫生

Objective To analyze the implementation of national training on quality control testing of radiodiagnostic and radiotherapy equipment from 2018 to 2022, and to summarize the effects of the training program. Methods We collected and analyzed the information on the national training program for quality control testing of radiodiagnostic and radiotherapy equipment organized by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention from 2018 to 2022. Results Five sessions of national training on quality control testing of radiodiagnostic and radiotherapy equipment were conducted from 2018 to 2022, with each session lasting four days. The proportion of teachers with senior professional titles was 87.5% (35/40). There were a total of 1045 attendances for radiological technician training, among which 75.1% (785/1045) had intermediate or lower technical titles and 87.1% (910/1045) had a bachelor’s degree or above. The qualified rate of training was 97.7% (905/926). In terms of the content, arrangement, and other key parts of training, the degrees of satisfaction of the trainees were all above 96.0%. Conclusion The national training program for quality control testing of radiodiagnostic and radiotherapy equipment worked well, with both the qualified rate and satisfaction degree above 95.0%. The program has helped professionals better understand and master the quality control testing of radiodiagnostic and radiotherapy equipment, and improved the high-quality development of continuing radiological education.

Relationship between metabolic syndrome and 1-year prognosis of elderly patients with acute cerebral infarction / 中国医师进修杂志

Objective:To investigate the relationship between metabolic syndrome and 1-year poor outcome in elderly patients with acute cerebral infarction (ACI).Methods:The clinical data of elderly patients with ACI admitted to Renqiu Kangjixintu Hospital from January 2014 to November 2018 were selected and divided into metabolic syndrome group (931 cases) and non-metabolic syndrome group (1 851 cases). The clinical data of the two groups of elderly patients with ACI were compared, and the effect of metabolic syndrome on poor outcome (modified Rankin scale>2 scores) of elderly patients with ACI in 1 year was analyzed by multivariate Logistic regression.Results:The proportion of female, hypertension, diabetes, hyperlipidemia, coronary heart disease, smoking, excessive alcohol consumption and antiplatelet drug use in the metabolic syndrome group were higher than those in the non-metabolic syndrome group: 52.74%(491/931) vs. 32.58%(603/1 851), 79.16%(737/931) vs. 64.29% (1 190/1 851), 42.32% (394/931) vs. 6.43% (119/1 851), 17.19% (160/931) vs. 11.62% (215/1 851), 18.90% (176/931) vs. 14.10% (261/1 851), 62.73% (584/931) vs. 50.89% (942/1 851), 3.73% (69/931) vs. 1.61% (15/1 851), 19.23% (179/931) vs. 15.51% (287/1 851), the levels of body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FPG), fasting plasma glucose (TG), total cholesterol (TC), platelet (PLT), fibrinogen (FIB), fall score were higher than those in non-metabolic syndrome group: 26.67 (25.31, 28.60) kg/m 2 vs. 23.30 (21.48, 24.91) kg/m 2, (167.17 ± 22.96) mmHg (1 mmHg = 0.133 kPa) vs. (164.21 ± 24.90) mmHg, (87.06 ± 13.10) mmHg vs. (85.76 ± 12.99) mmHg, (7.33 ± 2.64) mmol/L vs. (5.35 ± 1.38) mmol/L, (2.12 ± 1.51) mmol/L vs. (1.13 ± 0.78) mmol/L, (4.97 ± 1.31) mmol/L vs. (4.65 ± 0.99) mmol/L, 213.00 (179.00, 256.00) × 10 9/L vs. 203.00 (172.00, 241.00) × 10 9/L, 3.07 (2.63, 3.52) g/L vs. 2.94 (2.55, 3.37) g/L, (6.12 ± 1.70) scores vs. (5.93±1.74) scores, the levels of age, high density lipoprotein cholesterol (HDL-C), homocysteine (Hcy) and pressure ulcer score were lower than those of non-metabolic syndrome group: (69.29 ± 6.96) years vs. (71.28 ± 7.66) years, (0.98 ± 0.34) mmol/L vs. (1.31 ± 0.88) mmol/L, (18.93 ± 13.07) mmol/L vs. (21.66 ± 16.39) mmol/L, (18.55 ± 2.42) vs. (19.02 ± 2.43), with statistical significance ( P<0.05). After 1-year follow-up, the proportion of poor outcomes in the metabolic syndrome group was higher than that in the non-metabolic syndrome group: 21.70%(202/931) vs. 18.69% (346/1 851), with statistical significance ( P<0.05). Multivariate Logistic regression analysis showed that age, stroke, national institutes of health stroke scale (NIHSS) score at admission, systolic blood pressure, Hcy, pressure ulcer score, fall score, metabolic syndrome were independent risk factors for poor outcome of ACI in 1 year ( OR = 1.056, 1.309, 1.138, 1.005, 1.006, 0.882, 1.076 and 1.285; 95% CI 1.040 to 1.072, 1.037 to 1.652, 1.097 to 1.180, 1.000 to 1.010, 1.000 to 1.013, 0.834 to 0.933, 1.004 to 1.152 and 1.001 to 1.657; P<0.05). Conclusions:Multiple risk factors for stroke are closely related to poor outcome of ACI in the elderly. And metabolic syndrome is an independent risk factor for poor outcome of ACI in the elderly in 1 year.

Related factors and prevention of pigmentation in cutaneous neurovascular flap / 中华医学美学美容杂志

Objective:To explore the risk factors of skin flap pigmentation after repairing skin and soft tissue defects of extremities using cutaneous neurovascular flap and to give some suggestions for prevention and treatment.Methods:From January 2013 to March 2020, 160 cases of extremities cutaneous nerve vascular flap with survival in Tangshan Second Hospital were retrospectively studied. According to the occurrence of pigmentation, they were divided into two groups: Group A (pigmentation group) and Group B (non-pigmentation group). The observation indexes included sex, age, injury cause, defect size, complete debridement, anastomosis of skin flap, sunscreen measures and postoperative infection. First, univariate analysis was carried out to screen the influencing factors of pigmentation in the cutaneous neurovascular flap, and then Logistic regression was used for multivariate analysis to screen the risk factors.Results:The postoperative follow-up time was 12 to 24 months, with an average of 17.9 months. A total of 29 patients (18.1%) had skin flap pigmentation. Univariate analysis showed that there was no significant difference in sex, age, cause of injury and defect area between the two groups ( P>0.05). Further multivariate analysis showed that incomplete debridement, lack of venous anastomosis, failure to take sunscreen measures and postoperative infection were the risk factors of pigmentation of cutaneous neurovascular flap ( OR=0.310, 0.335, 0.355、5.878, 95% CI=0.112-0.863, 0.115-0.975, 0.133-0.949, 2.069-16.697, P<0.05). Conclusions:Incomplete debridement, lack of venous anastomosis, failure to take sunscreen measures and postoperative infection are the risk factors resulting in pigmentation of neurovascular flap. It is important to perform prevention to reduce the incidence of pigmentation.

Three-dimentional cultured adipose mesenchymal stem cells for alveolar cleft bone repair: an in vitro study / 中华医学美学美容杂志

Objective:To explore the osteogenic effect of adipose-derived mesenchymal stem cells (ADSCs) in three-dimensional culture conditions in Matrigel hydrogel to provide theoretical basis for tissue engineering bone repair of alveolar process fractures.Methods:This study was performed in the Laboratory of Guangzhou Women and Children Medical Center in June 2019. The fourth generation of ADSCs were used to adjust the cell density to 1×10 5/mL. Two-dimensional common culture media (group A) and two-dimensional osteogenic induction media (group B) were used. The ADSCs were encapsulated in hydrogel with osteogenic induction media (group C), and the proliferation of cells was detected by CCK8 method. The cell mineralization effect was detected by alizarin red staining and alkaline phosphatase activity. The expression levels of osteocalcin (OCN) and osteopontin (OPN) were detected by qRT-PCR and Western blot assay. Results:ADSCs were encapsulated in hydrogel. The results of CCK8 kit showed that ADSCs could stably proliferate under the three-dimensional culture. The alizarin red staining and alkaline phosphatase activity of ADSCs under three-dimensional culture conditions were significantly higher than those of two-dimensional condition. In the detection of Western blotting and RT-PCR, we found that the expression of osteogenic protein and mRNA (OCN and OPN) of ADSCs in three-dimensional culture was also higher than that of two-dimensional culture.Conclusions:The encapsulation of ADSCs in hydrogel does not affect the proliferative potential of stem cells, and 3D cultured stem cells can significantly enhance their osteogenesis in vitro.

Correlation between miR-206 expression and Wnt/β-catenin pathway in peripheral blood mononuclear cells of patients with hyperthyroidism / 中华地方病学杂志

Objective:To explore the correlation between the expression level of microRNA (miR)-206 and the expression levels of Wnt-1 and β-catenin in Wnt/β-catenin pathway in peripheral blood mononuclear cells of patients with hyperthyroidism.Methods:Using a prospective design, 79 patients with hyperthyroidism admitted to Wuwei City People's Hospital from January 2018 to June 2020 were selected as observation group, and 70 cases of healthy physical examination in Wuwei City People's Hospital from January 2019 to September 2020 were selected as control group. The observation group was treated with anti-thyroid drugs, and tambazole was orally taken 10-20 mg/d during the treatment period; after the serum thyroid hormone was normal, the dosage was reduced and maintained at 5-10 mg/d for 12 months. Quantitative real-time PCR (qRT-PCR) was used to detect the expression levels of miR-206, Wnt-1 and β-catenin mRNA in peripheral blood mononuclear cells in observation group before and after treatment and control group.Results:The expression level of miR-206 in peripheral blood mononuclear cells of observation group before treatment was lower than that of control group (0.28 ± 0.07 vs 0.79 ± 0.15), and the expression levels of Wnt-1 and β-catenin mRNA were higher than those of control group (6.75 ± 1.39 vs 2.23 ± 0.65, 5.83 ± 1.24 vs 3.21 ± 0.86, P < 0.05). The expression level of miR-206 (0.54 ± 0.13) in peripheral blood mononuclear cells of observation group after treatment was higher than that before treatment, and the expression levels of Wnt-1 and β-catenin mRNA (3.62 ± 1.08, 4.34 ± 1.16) were lower than those before treatment ( P < 0.05). The expression level of miR-206 in peripheral blood mononuclear cells of patients with hyperthyroidism was negatively correlated with the expression levels of Wnt-1 and β-catenin mRNA ( r = - 0.763, - 0.798, P < 0.05). Conclusions:The expression level of miR-206 in peripheral blood mononuclear cells of patients with hyperthyroidism is low, while the expression levels of Wnt-1 and β-catenin mRNA are high. The expression level of miR-206 is negatively correlated with the expression levels of Wnt-1 and β-catenin mRNA.

Effects of smoking and drinking status before operation on recurrence and metastasis of esophageal squamous cell carcinoma / 中国胸心血管外科临床杂志

@#Objective    To evaluate the effect of smoking and drinking status on the prognosis of patients with esophageal squamous cell carcinoma (ESCC). Methods    The clinical data of 483 patients with ESCC who underwent surgical treatment in Shannxi Provincial People's Hospital from 2007 to 2016 were retrospectively analyzed. Among them, 352 patients were male and 131 were female, with a median age of 64 (37-80) years. There were 311 smokers and 172 drinkers. The relationship between preoperative drinking or smoking status and the clinicopathological characteristics of patients with ESCC was analyzed. Log-rank method and Cox risk regression were used to conduct univariate and multivariate survival analysis, respectively. Results    The preoperative smoking status was related to the patient's tumor location (P=0.030). Drinking status was associated with tumor location (P=0.001), degree of differentiation (P=0.030), pathological T stage (P=0.024) and pathological N stage (P=0.029). Univariate survival analysis showed that smoking status did not affect the disease-free survival (DFS) (P=0.188) and overall survival (OS) (P=0.127) of patients with ESCC. However, patients who drank alcohol had worse PFS than non-drinking patients (29.37 months vs. 42.87 months, P=0.009). It was further proved that alcohol consumption was an independent risk factor affecting patients' recurrence and metastasis by using multivariate analysis (RR=1.28, P=0.040). Alcohol consumption also reduced the OS of patients by 21.47 months (P=0.014), however, multivariate analysis did not yield significant results. Conclusion    Preoperative drinking status is related to the stage and differentiation of patients with ESCC. It is an independent risk factor affecting the recurrence and metastasis of ESCC.

Initial exploration of choice of the donor site of flap and its repair strategy / 中华烧伤杂志

Objective@#To explore the choice of the donor site of flap and the repair method of secondary wound of flap donor site in tissue repair and reconstruction operation.@*Methods@#From January 2014 to September 2018, 62 cases of scar contracture deformity, 15 cases of skin tumor, 20 cases of skin and soft tissue injury, and 25 cases of chronic wound were admitted to the Burn Center of People′s Liberation Army of First Affiliated Hospital of Air Force Medical University, with 84 males and 38 females, aged from 3 to 89 years. Four repair strategies adopted for tissue repair and reconstruction and good repair of the donor site of flap were as follows: designing the flap rationally according to the condition around the wound or the size and shape of wound, choosing pre-expanded technique of the donor site of flap for repair of scar deformity optimally, making full use of the surrounding condition of flap donor site, and repaired with the distal flap, i. e. replacing the important site with secondary site. The donor site of flap was repaired by direct suture or peripheral flap and distal flap. The wound size of patients ranged from 3.0 cm×2.0 cm to 20.0 cm×18.0 cm, and the flap area ranged from 3.5 cm×2.0 cm to 25.0 cm×22.0 cm. The survival condition of flap, healing condition of donor site and recipient site, and follow-up condition of donor site and recipient site were recorded.@*Results@#Wounds of 122 patients were repaired with a total of 148 flaps designed by the above four repair strategies. All the flaps survived well, and the wound and flap donor site healed well. Follow-up for 3 to 36 months showed that the shape and function of recipient site and flap donor site were satisfactory.@*Conclusions@#According to the specific condition of the wound and anatomical structure of the surrounding tissue of flap donor site, overall surgical design with flexibility and personalization can achieve effects of good repair of the wound and reduce the secondary damage of flap donor site.

Selection of osteotomy line in mandibular distraction osteogenesis for infants and young children / 中华整形外科杂志

Objective@#To explore how to select osteotomy line and its significance in mandibular distraction osteogenesis in infants and young children.@*Methods@#From May 2013 to July 2018, 208 infants and young children with mandibular deformity were admitted to the Department of Oral and Maxillofacial Surgery, Guangzhou Women and Children Medical Center, including 131 males and 77 females, with the age range of 8 days to 4 years, mean age of 6 months. Their clinical records were retrospectively analyzed. There were 162 cases of Robin sequence, 37 cases of the first and branchial arch anomalies, 2 cases of Treacher-Collins syndrome, and 7 cases of other congenital malformations. During the distraction osteogenesis, different osteotomy lines were selected according to the characteristics of the mandibular deformity: (1) For short mandibular body, the straight osteotomy line was used to extend the mandibular body. (2) For short mandibular ramus, a polygonal osteotomy line was used to extend the ramus. (3) For the increased mandibular angle, a curved osteotomy line was used to change the angulation.@*Results@#Linear osteotomy was used in 38 patients, polygonal line osteotomy were used in 129 patients, and curved osteotomy was performed in 41 patients. Among them, 4 patients with linear osteotomy had deciduous embryo injury, 6 patients with linear osteotomy and 2 patients with polygonal osteotomy had open occlusion, and patients with curved osteotomy did not have tooth and mandible damage, or malocclusion. All patients were followed up for 3 months to 5 years. The average follow-up time was 6.2 months. All osteotomy healed well, without osteonecrosis or nonunion.@*Conclusions@#For the mandibular distraction osteogenesis, osteotomy line could be individualized, according to the characteristics of mandibular deformity of infants and young children, which can reduce complications such as dental damage and open occlusion.

Application of low temperature thermoplastic plate combined with special abdominal band in fixing abdominal pedicled flap for repairing 17 patients with deep electric burn wounds in hands / 中华烧伤杂志

If the abdominal pedicled flaps are not well fixed after repair of deep electric burn wounds in hands, many problems such as poor blood supply may occur. In order to solve the above problems, we designed and manufactured the individualized low temperature thermoplastic plate combined with special abdominal band to fix abdominal pedicled flaps for repairing of 17 patients (12 males and 5 females, aged 2-35 years) with deep electric burn wounds in hands from February 2016 to August 2018, and achieved the desired results. The shoulder joint, elbow joint, and wrist joint were fixed by low temperature thermoplastic plate according to the 1/2 circumference of the patient′s side chest and upper arm, and the braking of wrist joint and elbow joint was strengthened by special abdominal band. Application of the combined method of fixing abdominal pedicled flaps in repairing deep electric burn wounds in hands has high success rate of flap transplantation. It is simple to make and practical, and worthy of clinical promotion.

Application of strip crown form in aesthetic restoration of mandibular deciduous incisors in severe childhood caries / 中华医学美学美容杂志

Objective To explore the feasibility and effectiveness of aesthetic restoration of caries of mandibular deciduous incisors with strip crown form of maxillary deciduous incisors.Methods A total of 64 patients (202 teeth) with symmetrical caries of bilateral mandibular central incisors or lateral incisors were randomly selected.The opposite maxillary incisors were restored with strip crowns form and the opposite incisors were restored with resin composite.The effects of the two methods and the incidence of complications were compared three months,six months and twelve months after treatment.Results Three months after treatment,there was no significant difference in the success rate between the two groups.Six months after treatment,there was significant differencein the marginal adaptation between the two groups (x2 =3.919,P =0.048);12 months after treatment,there was significant difference in the restoration integrity of the two groups and the incidence of secondary caries (x2 =5.027,P =0.025;secondary caries x2 =4.369,P =0.037).Conclusions The strip crown form of maxillary primary incisors can be used for aesthetic restoration of caries of mandibular primary incisors,and its effect is better than that of direct resin filling.The strip crown form for mandibular primary incisors needs to be developed and produced urgently.

Effect of electroacupuncture preconditioning on postoperative delirium and early outcomes in pa-tients undergoing cardiac valve replacement with cardiopulmonary bypass / 中华麻醉学杂志

Objective To evaluate the effect of electroacupuncture preconditioning on postoperative delirium ( POD) and early outcomes in the patients undergoing cardiac valve replacement with cardiopulmo-nary bypass. Methods Sixty American Society of Anesthesiologists physical statusⅡorⅢpatients of both sexes, of New York Heart Association Ⅱ or Ⅲ, aged 28-64 yr, scheduled for elective cardiac valve re-placement with cardiopulmonary bypass, were divided into 2 groups ( n=30 each) using a random number table method: control group ( group C ) and electroacupuncture preconditioning group ( group EA ) . In group EA, Baihui, Yintang and Renzhong acupoints were stimulated for 30 min with an electric stimulator ( sparse-dense wave, frequency 2/15 Hz, intensity 1 mA) before skin incision. rSO2 was continuously mo-nitored during operation, and the mean rSO2 ( rSO2 mean ) , the minimal rSO2 ( rSO2min ) and the maximal percentage of decrease from baseline in rSO2 ( rSO2％max ) were calculated. Blood samples were collected be-fore the electroacupuncture, at the end of surgery, and at 6, 24 and 72 h after surgery for determination of serum tumor necrosis factor-alpha, interleukin-6 ( IL-6) , IL-10, neuron-specific enolase and S100β pro-tein concentrations by enzyme-linked immunosorbent assay. POD was assessed by Confusion Assessment Method for Intensive Care Unit, and the postoperative recovery was evaluated by Quality of Recovery-40 Questionnaire. The occurrence of POD, duration of stay in intensive care unit and length of hospital stay were also recorded. Results Compared with group C, the rSO2％max , serum concentrations of tumor nec-rosis factor-alpha, IL-6, neuron-specific enolase and S100βprotein and incidence of POD were significant-ly decreased, the rSO2min , serum IL-10 concentration and Quality of Recovery-40 Questionnaire score were increased, and the duration of stay in intensive care unit and length of hospital stay were shortened ( P＜0. 05) , and no significant change was found in rSO2mean in group EA ( P＞0. 05) . Conclusion Electroacu-puncture preconditioning decreases the occurrence of POD and improves early outcomes in the patients un-dergoing cardiac valve replacement with cardiopulmonary bypass.

Chromosomal microarray analysis in the prenatal diagnosis of orofacial clefts: Experience from a single medical center in mainland China.

The aim of this study was to investigate the value of chromosomal microarray analysis (CMA) for the prenatal diagnosis of orofacial clefts.A total of 143 fetuses with oral clefts were detected by ultrasound during prenatal exam between 2012 and 2017 in our center. We categorized the cases into 4 groups: isolated cleft lip (CL) (CL only), isolated cleft palate (CP only), isolated cleft lip and palate (CLP) (CLP only), and syndromic CLP (combined with other malformations). The CMA was performed in all cases, while 139 fetuses were referred for G-banded chromosome analysis.There were 42 male and 10 female fetuses were born, with a sex ratio of 4.2:1. The isolated CLP group accounted for 74.1% (106/143) of cases, while the isolated CL, isolated CP, and syndromic CP groups accounted for 13.9% (20/143), 2% (3/143), and 10% (14/143), respectively. A total of 11 fetuses had pathogenic copy number variants (CNVs, 7.7%), including isolated CP (1/143, 0.7%), isolated CLP (5/143, 3.5%), and syndromic CLP (5/143, 3.5%). Compared with the CMA results, 5 fetuses were found to have an abnormal karyotype (5/139, 3.6%). However, no abnormalities were found in either karyotype analysis or CMA in the isolated CL group.CMA is a valuable tool for identifying submicroscopic chromosomal abnormalities in the prenatal diagnosis of oral clefts. An excellent outcome can be expected for fetuses with isolated CL that are negative for chromosomal abnormalities.

Clinical efficacy observation on combination of narrow-spectrum medium-wave ultraviolet, red light, and low power He-Ne laser in treating post-burn eczema / 中华烧伤杂志

Objective@#To investigate the clinical effects of combined utilization of narrow-spectrum medium-wave ultraviolet, red light, and low power He-Ne laser on treatment of post-burn eczema.@*Methods@#From July 2014 to July 2017, 80 patients with post-burn eczema who met the study inclusion criteria were treated in our burn rehabilitation center, and their clinical data were analyzed retrospectively. Patients were divided into ultraviolet treatment group, red light treatment group, laser treatment group, and combination treatment group according to the utilized treatment methods, with 20 cases in each group. Patients in ultraviolet treatment group were treated with narrow-spectrum medium-wave ultraviolet once every other day for 10 minutes each time. Patients in red light treatment group and laser treatment group were treated with red-light and low power He-Ne laser respectively once a day for 10 minutes each time. Patients in combination treatment group were treated with combination of the above three methods without sequence or interval time, and the treatment time and interval time were the same as the previously described. All patients were treated for four weeks since the time of admission. The itching degree, surface area of the affected body, degree of keratosis, and degree of cracking of target tissue were evaluated using Eczema Area and Severity Index (EASI) scoring method after each treatment. Eczema improvement rate was calculated according to the total score of EASI to determine the curative effect. The therapeutic effective time was recorded. The therapeutic effective rate was calculated according to the total scores of EASI before treatment for the first time and 4 weeks after treatment. Besides, the adverse reactions of patients were also observed and recorded. Data were analyzed by Chi-square test, Kruskal-Wallis rank sum test, Wilcoxon signed rank sum test, one-way analysis of variance, Least Significant Difference-t test, and Bonferroni correction.@*Results@#Therapeutic effective times of eczema of patients in ultraviolet treatment group, red light treatment group, and laser treatment group were similar, respectively (13.7±1.3), (16.4±1.6), and (15.1±1.7) d (t=0.32, 0.58, 0.74, P>0.05). The therapeutic effective time of combination treatment group was (6.3±0.9) d, significantly shorter than that of ultraviolet treatment group, red light treatment group, or laser treatment group (t=5.62, 4.72, 4.61, P<0.05 or P<0.01). Compared with those before treatment for the first time, eczema itching degree, surface area of affected body, degree of keratosis, degree of cracking, and total score of EASI of patients in ultraviolet treatment group, red light treatment group, laser treatment group, and combination treatment group showed obvious improvement in 4 weeks after treatment (Z=5.372, 4.392, 4.284, 3.998, 4.092, 3.904, 4.042, 4.216, 3.684, 3.890, 5.081, 4.794, 4.094, 3.493, 3.995, 5.084, 4.903, 4.384, 3.995, 4.063, P<0.05 or P<0.01). Each item score and total score of EASI of eczema of patients in the first three groups were close (P>0.05), while each item score and total score of EASI of eczema of patients in combination treatment group was significantly better than those of ultraviolet treatment group, red light treatment group, and laser treatment group (H=2.482, 2.491, 3.583, 3.462, 6.025, 2.492, 3.693, 3.085, 3.482, 6.042, 5.831, 5.831, 4.893, 4.092, 6.931, P<0.05). Therapeutic effective rates of eczema of patients in ultraviolet treatment group, red light treatment group, and laser treatment group were close, respectively 60%, 60%, and 55% (χ2=1.46, 1.63, 0.97, P>0.05). The therapeutic effective rate of eczema of patients in combination treatment group was 90%, significantly higher than that of ultraviolet treatment group, red light treatment group, or laser treatment group (χ2=3.43, 4.15, 2.97, P<0.05 or P<0.01). There were no serious adverse reactions appeared in patients of all the four groups after treatment. Three patients in ultraviolet treatment group had local skin erythema, which was alleviated after symptomatic treatment.@*Conclusions@#Combination of narrow-spectrum medium-wave ultraviolet, red light, and low power He-Ne laser in treating post-burn eczema is superior to single therapy in terms of clinical effective time and efficacy, which has no obvious adverse reaction and is worthy of promotion.

Clinical efficacy of miniplates anchorage between the maxilla and the mandible for maxillary hypoplasia in cleft patients / 中华医学美学美容杂志

Objective To investigate the effects of titanium miniplates used for anchorage between the maxilla and the mandible for maxilly hypoplasia in cleft patients.Methods Miniplates were inserted into the infrazygomatic crests and between the canine and lateral incisor in the mandible on both the right and left sides in 6 subjects (mean age,11.3 years).Maxillomandibular elastics were attached between the upper and lower miniplates on each side.Cephalometric radiographs of each patient were evaluated at the beginning of treatment and at the end of active protraction treatment.Results A-point movement was increased mean 3.67 mm,SNA angle and ANB angle were increased by 2.75° and 3.1° respectively.Wit's appraisal was increased by 4.52 mm,and upper lip to E-plane was decreased mean 2.8 mm in a mean of 15 months and the significant difference was found (P＜0.05).Miniplates stability was excellent in all patients throughout treatment.Conclusions Remarkable advancement in the middle face and consequent fullness in the soft-tissue profile can be achieved by using titanium miniplates protraction for maxilly hypoplasia in cleft patients in the late mixed-dentition and initial stage of permanent dentition period.

[Application of team approach and key techniques of cleft lip and palate].

The development of an expert consensus based on specific domestic situations will provide practical guidance to the efforts aiming at improving cleft care in China. The team approach of twenty-one cleft centers were pooled together, covering pre-surgical orthopedics, primary surgical repair, orthodontic treatment, alveolar bone graft, secondary deformity correction, palatal fistulae repair, the diagnosis and treatment of velopharyngeal incompetence, speech therapy, otitis media management, and skeletal deformity correction. Agreement was achieved among the authors concerning the application of critical surgical and non-surgical techniques. The ambition of this consensus is to introduce more clinicians to the revolution of sequential treatment of clefts, and form the basis for a more comprehensive cleft care manual in the future.

The design and clinical application of anterior branch of subcostal artery perforator flap / 中华整形外科杂志

Objective@#To investigate the anterior branch of subcostal artery perforator flap for defects at the lower abdomen or distal sites.@*Methods@#Ten patients were treated, including 6 males and 4 females, aged 25 to 62 years, mean (38.2 ± 6.5) years old. The anterior branch of subcostal artery perforator flap was designed in 10 cases, of which 1 case was free flap carrying the accompanying nerve. 9 cases had defects at abdomen and 1 case at the foot. The flaps size was 4 cm×8 cm-7 cm ×15 cm.@*Results@#All the 10 flaps survived completely with no vascular crisis. The abdominal shape was good with only linear scar. The free flap was used for plantar wound with nerve anastomosis of accompanying nerve with the medial plantar nerve. During the follow-up period of 6 months, the flap sensory recovery area reached more than 60% with two-point discrimination as 20-25 mm.@*Conclusions@#The anterior branch of subcostal artery perforator flap has a stable vascular pedicle with reliable vascular network and sensory nerve.

Association of serum miRNA6086 expression with postoperative anal fistula recurrence / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association between serum miRNA-6086 expression level and anal fistula recurrence.</p><p><b>METHODS</b>Clinical data and serum samples of 60 patients with anal fistula and mix hemorrhoid identified by pathology undergoing resection in our department from August 2015 to August 2016 were collected. In addition, serum samples of 20 patients matching with fistula group in age, gender and body weight and receiving only hemorroidectomy were collected as control during the same period. Serum miRNA6086 expression level was detected by real-time quantitative RT-PCR method, and the association of serum miRNA6086 expression level with clinicopathologic features was analyzed. Univariate ANOVA test and multivariate logistic regression analysis were performed to analyze the association between serum miRNA6086 expression level and anal fistula recurrence.</p><p><b>RESULTS</b>The relative expression of serum miRNA6086 in fistula group was 65.85±15.57, which was significantly up-regulated for 4.87 folds of 13.52±7.32 in control group(P<0.05). In fistula group, 24 cases(40%) developed anal fistula recurrence, whose serum miRNA6086 expression was significantly higher compared to 36 cases without recurrence (74.06±12.92 vs. 60.38±14.90, P<0.05). No associations of serum miRNA6086 expression with age, gender, BMI, drug history, acute phase were observed (P>0.05), while association of serum miRNA6086 expression level with the type, number and position of anal fistula was significant (all P<0.05). Univariated analysis indicated that anal fistula type (χ=6.890, P=0.009), anal fistula number (χ=0.554, P<0.001) and serum miRNA6086 expression (χ=11.390, P=0.001) were significantly associated with anal fistula recurrence. Multivariate logistic regression analysis showed that complex anal fistula (OR=4.75, 95%CI: 1.84 to 12.01, P=0.001) and high expression of serum miRNA6086 (OR=3.22, 95%CI:1.31 to 8.22, P=0.011) were independent risk factors of anal fistula recurrence.</p><p><b>CONCLUSION</b>Up-regulated expression of serum miRNA6086 is associated to the anal fistula type and may be valuable in predicting the prognosis.</p>

Simultaneous esophagectomy and off-pump coronary artery bypass grafting for esophageal cancer:a report of five cases with literature review / 中华胸心血管外科杂志

Objective To explore the possibility and safety of the simultaneous esophagectomy and off-pump coronary artery bypass grafting(OPCABG) in patients suffering from esophageal cancer combined with coronary artery and summarize the clinical experiences.Methods We retrospectively analyzed the clinical dates of 5 patients performed at the Henan province Chest Hospital from May 2009 to December 2014.The related literature was reviewed.Results All patients were performed the simultaneous esophagectomy and OPCABG through the single left posterolateral thoracotomy 4cases and through median sternotomy and left thoracotomy 1 case.Instrument anastomosis under aortic arch 2 cases and above aortic arch 1 case , left neck anastomosis by hand 2 cases.Coronary artery three ressel disease 3cases, double-vessel 1 case, left main single vessel 1 case.There was no hospital death in this series.Postoperative complications included arrhythmia,anastomotic fistula and pneumonia.Only one patient was still alive, the other patients died of tumor recurrence or metastasis and median survival time was 20.6 months.Conclusion Simultaneous esophagectomy and OPCABG is a safe and feasible treatment modality in patients with severe CAD and esophageal cancer and it may be more beneficial for the patient with early esophageal cancer.