Progress in the application of neurosonography in monitoring the patients with acute ischemic stroke after receiving mechanical thrombectomy / 介入放射学杂志

At present,mechanical thrombectomy(MT)is the most effective means of achieving vascular recanalization in treating acute ischemic stroke(AIS)caused by large vessel occlusion.However,the monitoring and management of the patient's complications after MT has become a thorny clinical problem and it has attracted wide attention.Being of its non-invasive,flexible and quick diagnosis,and other advantages,the neurosonography has already established a perfect system in the evaluation and monitoring field of cerebral hemodynamic and structural pathology.With the innovation in technology and equipment,the guiding mode for non-invasive monitoring of intracranial pressure,autoregulation of cerebral blood flow,monitoring of intracranial hemorrhage and detection of other space-occupying lesions has been used for AIS patients,which has gradually become an important tool for the postoperative management of MT.This paper aims to make a comprehensive review about the application of neurosonography monitoring technology in AIS patients after MT,so as to provide a basis for the clinical implementation of prospective interventions,to enable AIS patients to obtain the maximum benefits from the postoperative management of MT,and to reduce the mortality of AIS patients.

Study on molecular mechanism of etomidate by promoting expression of miR-142-3p to reduce hypoxia-induced neuro-inflammatory response and cell apoptosis in PC12 cells / 中国免疫学杂志

Objective:To investigate whether etomidate affects inflammatory response and apoptosis of PC12 cells induced by hypoxia by regulating miR-142-3p.Methods:PC12 cells were pretreated with different doses(2,6,12 μmol/L)of etomidate to establish hypoxia model;PC12 cells that transfected with miR-142-3p mimics or inhibitors were pretreated with 0 or 12 μmol/L of etomidate to establish hypoxia model.Cell viability,apoptosis and protein(CyclinD1,Cleaved-caspase-3)expressions were detected by CCK-8 method,flow cytometry and Western blot,respectively.ELISA was used to detect levels of inflammatory factors TNF-α,IL-1β,IL-6.Expression of miR-142-3p was detected by RT-qPCR.Results:Etomidate increased hypoxia-induced PC12 cells activity and expres-sion of CyclinD1 protein and miR-142-3p,while decreased cell apoptosis rate,Cleaved-caspase-3 protein expression and levels of inflammatory factors TNF-α,IL-1β,IL-6(P<0.05).Up-regulation of miR-142-3p increased activity and expression of CyclinD1 pro-tein of hypoxia-induced PC12 cells,while decreased cell apoptosis rate,Cleaved-caspase-3 protein expression and levels of inflamma-tory factors TNF-α,IL-1β,IL-6(P<0.05).Down-regulation of miR-142-3p reversed effects of etomidate on hypoxia-induced PC12 cell activity,apoptosis and expressions of inflammatory factors(P<0.05).Conclusion:Etomidate can reduce inflammatory response and apoptosis of PC12 cells induced by hypoxia,and its mechanism may be related to the up-regulation of miR-142-3p expression in cells.

Extensive neutralization against SARS-CoV-2 variants elicited by Omicron-specific subunit vaccine booster

The currently dominant variant of SARS-CoV-2 Omicron, carrying a great number of mutations, has been verified its strong capacity of immune escape in COVID-19 convalescents and vaccinated individuals. An increased risk of SARS-CoV-2 reinfection or breakthrough infection should be concerned. Here we reported higher humoral immune response elicited by Delta and Omicron variants after breaking through previous infection and cross-neutralization against VOCs, compared to the ancestral wild-type (WT) virus infection. To overcome the immune escape of Omicron, Omicron-specific vaccine was considered as a novel and potential strategy. Mouse models were used to verify whether Omicron-specific RBD subunit boost immune response by immunizing Omicron-RBD recombinant proteins. Three doses of Omicron-RBD immunization elicit comparable neutralizing antibody (NAb) titers with three doses of WT-RBD immunization, but the neutralizing activity was not cross-active. By contrast, two doses of WT-RBD with an Omicron-RBD booster increased the NAb geometric mean titers against Omicron by 9 folds. Moreover, an additional boost vaccination with Omicron-RBD protein could increase humoral immune response against both WT and current VOCs. These results suggest that the Omicron-specific subunit booster shows its advantages in the immune protection from both WT and current VOCs, and that SARS-CoV-2 vaccines administration using two or more virus lineages as antigens might improve the NAb response.

Reduced infectivity but increased immune escape of the new SARS-CoV-2 variant of concern Omicron

A new detected SARS-CoV-2 variant Omicron (B.1.1.529) had reported from more than 80 countries. In the past few weeks, a new wave of infection driven by Omicron is in progress. Omicron Spike (S) protein pseudotyped virus was used to determine the effect of S mutations on its capacity of infectivity and immune evasion. Our results showed the lower entry efficiency and less cleavage ability of Omicron than D614G variant. Pseudotype-based neutralizing assay was performed to analyze neutralizing antibodies elicited by previously infection or the RBD-based protein subunit vaccine ZF2001 against the Omicron variant. Sera sampled at around one month after symptom onset from 12 convalescents who were previously infected by SARS-CoV-2 original strain shows a more than 20-fold decrease of neutralizing activity against Omicron variant, when compared to D614G variant. Among 12 individuals vaccinated by RBD subunit vaccine, 58.3% (7/12) sera sampled at 15-60 days after 3rd-dose vaccination did not neutralize Omicron. Geometric mean titers (GMTs, 50% inhibitory dose [ID50]) of these sera against Omicron were 9.4-fold lower than against D614G. These results suggested a higher risk of Omicron breakthrough infections and reduced efficiency of the protective immunity elicited by existing vaccines. There are important implications about the modification and optimization of the current epidemic prevention and control including vaccine strategies and therapeutic antibodies against Omicron variant.

Reduced neutralization of SARS-CoV-2 B.1.617 variant by inactivated and RBD-subunit vaccine

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Spike protein that mediates coronavirus entry into host cells is a major target for COVID-19 vaccines and antibody therapeutics. However, multiple variants of SARS-CoV-2 have emerged, which may potentially compromise vaccine effectiveness. Using a pseudovirus-based assay, we evaluated SARS-CoV-2 cell entry mediated by the viral Spike B.1.617 and B.1.1.7 variants. We also compared the neutralization ability of monoclonal antibodies from convalescent sera and neutralizing antibodies (NAbs) elicited by CoronaVac (inactivated vaccine) and ZF2001 (RBD-subunit vaccine) against B.1.617 and B.1.1.7 variants. Our results showed that, compared to D614G and B.1.1.7 variants, B.1.617 shows enhanced viral entry and membrane fusion, as well as more resistant to antibody neutralization. These findings have important implications for understanding viral infectivity and for immunization policy against SARS-CoV-2 variants.

Emerging SARS-CoV-2 variants reduce neutralization sensitivity to convalescent sera and monoclonal antibodies

SARS-CoV-2 Spike-specific antibodies contribute the majority of the neutralizing activity in most convalescent human sera. Two SARS-CoV-2 variants, N501Y.V1 (also known as B.1.1.7 lineage or VOC-202012/01) and N501Y.V2 (B.1.351 lineage), reported from the United Kingdom and South Africa, contain several mutations in the receptor binding domain of Spike and are of particular concern. To address the infectivity and neutralization escape phenotypes potentially caused by these mutations, we used SARS-CoV-2 pseudovirus system to compare the viral infectivity, as well as the neutralization activities of convalescent sera and monoclonal antibodies (mAbs) against SARS-CoV-2 variants. Our results showed that N501Y Variant 1 and Variant 2 increase viral infectivity compared to the reference strain (wild-type, WT) in vitro. At 8 months after symptom onset, 17 serum samples of 20 participants (85%) retaining titers of ID50 >40 against WT pseudovirus, whereas the NAb titers of 8 samples (40%) and 18 samples (90%) decreased below the threshold against N501Y.V1 and N501Y.V2, respectively. In addition, both N501Y Variant 1 and Variant 2 reduced neutralization sensitivity to most (6/8) mAbs tested, while N501Y.V2 even abrogated neutralizing activity of two mAbs. Taken together the results suggest that N501Y.V1 and N501Y.V2 reduce neutralization sensitivity to some convalescent sera and mAbs.

Changes of Humoral Immunity Response in SARS-CoV-2 Convalescent Patients over 8 months

Many countries around the world have all seen a sharp rise in COVID-19 cases as the second wave since the beginning of October 2020. Decline of antibodies response to severe acute respiratory syndrome coronavirus (SARS-CoV-2) that was reported exclusively in the early month increases the risk of reinfection for convalescent individuals. There is a current need to follow the maintenance of special antibodies against SARS-CoV-2. Here, we reported changes of antibodies against SARS-CoV-2 in convalescent patients over 8 months. Antibodies of all 20 participants targeting SARS-CoV-2 spike receptor binding-domain (RBD) had decreased from a mean OD450 value 1.78 to 0.38 over 8 months. The neutralizing antibody (NAb) titers decreased from the mean ID50 value 836 to 170. The NAb titers were significantly correlated with IgG level during 8 months (P<0.001). Furthermore, while RBD-specific IgG existence of 25% (5/20) convalescent plasma was undetectable, the NAb titers of 15% (3/20) convalescent plasma decreased below the threshold. In addition, compared to wild-type SARS-CoV-2 (S-D614), lower titers of neutralizing antibodies against its G614 variant were shown at 8 months after symptom onset. This study has important implications when considering antibody protection against SARS-CoV-2 reinfection.

Clinical effects of expanded forehead flaps in repairing midfacial defects / 中华烧伤杂志

Objective@#To explore the clinical effects of expanded forehead flaps in repairing midfacial defects.@*Methods@#From January 2003 to December 2018, 19 patients with midfacial defects were admitted to our unit, including 8 males and 11 females, aged 7 to 52 years. One cylindrical expander with rated capacity ranged from 100 to 170 mL was placed in the forehead of patients in the first stage of expansion, and the total water injection volume was about 2 times of the rated capacity of the expander during 1 to 2 months. The area of midfacial defects was 4 cm×2 cm to 9 cm×5 cm after resection in the second stage surgery. Expanded forehead flaps with vascular pedicle of supratrochlear vessels or frontal branch of superficial temporal vessels were used to repair the midfacial defects, with flap size ranging from 5 cm×2 cm to 16 cm×6 cm. The donor sites were closed by direct suturing. Three weeks later, the pedicle was divided. The complications, blood supply after flap transfer and pedicle division, and the treatment effects during follow-up were observed.@*Results@#Among the patients, flaps of 11 patients had vascular pedicle of supratrochlear vessels; flaps of 8 patients had vascular pedicle of frontal branch of superficial temporal vessels. All the flaps survived with no complications and good blood supply after flap transfer and pedicle division. During the follow-up of 6 to 12 months after the third stage surgery of pedicle division of 12 patients, no lower eyelid ectropion occurred, the appearance of the flaps was similar to the surrounding tissue with no swelling.@*Conclusions@#The application of expanded forehead flaps can not only repair the defects but also effectively avoid the complication of lower eyelid ectropion, which is a promising method in repairing midfacial defects.

Application of 3D imaging technology in preoperative evaluation of breast conserving surgery / 中国肿瘤临床

Objective: To evaluate 3D imaging technology in the preoperative evaluation of breast conserving surgery. Methods: A ret-rospective analysis was conducted using clinical data from 38 patients who underwent breast conserving surgery that was assisted by 3D imaging technology in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from April 2017 to January 2019. All 38 patients underwent 3.0-T breast magnetic resonance imaging (MRI) examination before surgery, and 3D reconstruction of virtu-al images was constructed through 3D modeling of medical digital imaging and communication (DICOM) data. The predicted resected tissue volume was compared with the volume of the actual resected specimen, and the surgical margin and postoperative aesthetics of the breast conserving surgery were evaluated. Results: The reconstructed 3D model clearly displayed the anatomical structures of the breast, tumor, gland, and blood vessels, and their relationship in 3D spaces. The goodness of fit of the 3D model to the practical sit-uation was 97.4% (37/38). In terms of the resection tissue volume, there was no significant difference between the predicted results (PRTV) and actual results (ARTV) [(61.7 ± 20.1) mL vs. (65.1 ± 20.7) mL, P>0.05]. There was a strong positive correlation between ARTV and PRTV (P<0.01). One patient underwent supplementary secondary surgery, resulting in an incidence of 2.6% (1/38). The postopera-tive satisfaction for breast conserving surgery was 100% (38/38). Conclusions: 3D imaging technology clearly displays the anatomical relationship between breast tumor and surrounding tissues, and correctly assesses breast volume, guiding surgical resection.

Treatment of recurrent severe blepharoptosis after frontal muscle flap suspension and levator palpebrae superioris shortening with conjoint fascia sheath suspension / 中华医学美学美容杂志

Objective@#To investigate the clinical effect of conjoint fascial sheath (CFS) suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis.@*Methods@#From February 2017 to April 2018, 19 severe blepharoptosis patients (21 eyelids) were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening, and repaired through the technology of CFS suspension.@*Results@#There were 19 cases, 17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes, and the other 2 cases obtained satisfactory results though reoperation. There were no complications of exposure keratitis, ectropion and infection occurred. Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months.@*Conclusions@#The application of conjoint fascial sheath (CFS) suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.

Expressions of CD97 isoforms in colon cancer tissues and their clinical significances / 肿瘤研究与临床

Objective To study the mRNA expressions of various CD97 isoforms in colorectal carcinoma tissues and their clinical significances. Methods A total of 50 colon cancer patients in the First Affiliated Hospital of Wenzhou Medical University from December 2013 to May 2014 and human colon cancer cell lines SW480 and SW620 were enrolled. The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expressions of CD97 human epidermal growth factor (EGF) (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in colon cancer tissues, adjacent tissues, normal colon tissues, SW480 cells and SW620 cells. The relationship between the mRNA expression of CD97EGF (1, 2, 5) and the clinicopathological factors was analyzed. Results Compared with those low expressions in adjacent tissues and normal tissues, the mRNA expressions of CD97 isoforms CD97EGF (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in cancer tissues were highest, and the differences were statistically significant (0.71±0.20 vs. 0.40±0.09 vs. 0.35±0.07, F=107.642, P<0.01;0.45±0.11 vs. 0.26±0.05 vs. 0.27±0.06, F=94.231, P< 0.01; 0.41±0.10 vs. 0.21±0.05 vs. 0.19±0.03, F= 165.672, P< 0.01). In addition, the mRNA expression of CD97EGF (1, 2, 5) in colon cancer patients was associated with tumor infiltration depth (T1-T2 and T3-T4), clinical stages (Ⅰ-Ⅱ and Ⅲ-Ⅳ), and the differences were statistically significant (t= -2.582, P= 0.013; t= -5.062, P< 0.01). The mRNA expression of CD97EGF (1, 2, 5) in SW620 cells was higher than that in SW480 cells. Conclusions CD97 isoforms are highly expressed in colon cancer tissues, and CD97EGF (1, 2, 5) may play an important role in the development and invasion of colon cancer. The CD97 isoforms may be new markers in the treatment of colon cancer.

Expressions of CD97 isoforms in colon cancer tissues and their clinical significances / 肿瘤研究与临床

Objective@#To study the mRNA expressions of various CD97 isoforms in colorectal carcinoma tissues and their clinical significances.@*Methods@#A total of 50 colon cancer patients in the First Affiliated Hospital of Wenzhou Medical University from December 2013 to May 2014 and human colon cancer cell lines SW480 and SW620 were enrolled. The real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expressions of CD97 human epidermal growth factor (EGF) (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in colon cancer tissues, adjacent tissues, normal colon tissues, SW480 cells and SW620 cells. The relationship between the mRNA expression of CD97EGF (1, 2, 5) and the clinicopathological factors was analyzed.@*Results@#Compared with those low expressions in adjacent tissues and normal tissues, the mRNA expressions of CD97 isoforms CD97EGF (1, 2, 5), CD97EGF (1, 2, 3, 5) and CD97EGF (1, 2, 3, 4, 5) in cancer tissues were highest, and the differences were statistically significant (0.71±0.20 vs. 0.40±0.09 vs. 0.35±0.07, F = 107.642, P < 0.01; 0.45±0.11 vs. 0.26±0.05 vs. 0.27±0.06, F = 94.231, P < 0.01; 0.41±0.10 vs. 0.21±0.05 vs. 0.19±0.03, F = 165.672, P < 0.01). In addition, the mRNA expression of CD97EGF (1, 2, 5) in colon cancer patients was associated with tumor infiltration depth (T1-T2 and T3-T4), clinical stages (Ⅰ-Ⅱ and Ⅲ-Ⅳ), and the differences were statistically significant (t = -2.582, P = 0.013; t = -5.062, P < 0.01). The mRNA expression of CD97EGF (1, 2, 5) in SW620 cells was higher than that in SW480 cells.@*Conclusions@#CD97 isoforms are highly expressed in colon cancer tissues, and CD97EGF (1, 2, 5) may play an important role in the development and invasion of colon cancer. The CD97 isoforms may be new markers in the treatment of colon cancer.

Repair of large and medium size facial skin and soft tissue defects by the free expanded deltopectoral flap / 中华整形外科杂志

Objective@#To evaluate the application of the expanded free deltopectoral flap, pedicled with perforation of internal thoracic artery, in the repairment of middle to large facial skin and soft tissue defect.@*Methods@#From June 2015 to December 2017, 11cases diagnosed with facial lesions were included in this study. The tissue defect of 10 cases were caused by burn, and 1 case by superficial tumor. In the first stage, the tissue expander was implanted into the internal thoracic artery supplying area. After the expander was fully expanded, the second surgery, i. e. the resection of facial lesion, was performed. The defect areas of patients, with the range of 9 cm×7 cm to 17 cm×10 cm, were repaired by expanded free deltopectoral flaps.@*Results@#All flaps were survived, with no vascular crisis occurred. The size of flaps ranged from 10.0 cm×9.0 cm to 18.0 cm×11.5 cm. All the patients were satisfied with the outcomes, after 6 to 24 months follow-up. The color and texture of flaps was close to normal. The scars were acceptable.@*Conclusions@#The expanded free deltopectoral flap, pedicled with the perforator of internal thoracic artery, is a promising way to repair middle to large facial skin and soft tissue defect.

Therapeutical effect of ferulic acid on rabbit ear chronic ischemic wounds / 中华医学美学美容杂志

Objective To study whether ferulic acid can promote healing on chronic ischemic wounds and its possible mechanisms.Methods 40 male New Zealand white rabbits were randomly divided into 4 groups:vaseline group,ischemic control group,5％ ferulic acid group and recombinant bovine basic fibroblast growth factor for external use (rb-bFGF) group.Gross wounds were carefully observed and HE staining was used to observe the wound healing and immumohistochemical staining to observe the expression of the VEGF and CD31.The RNA was extracted to detect the expression of VEGF and HIF-1a by real-time PCR.Results The general observation and the HE staining of each specimen 11 days after operation all indicated that the duration of wound healing of the 5 ％ ferulic acid group was similar to that of the rb-bFGF group and markedly shorter than the ischemic control group and the vaseline smear group.The result of the immunohistochemical staining indicated that the content of the VEGF and CD31 expression of the 5 ％ ferulic acid groups and the rb-bFGF group made lit tle difference,but there was markedly less VEGF and CD31 in ischemic control group and the vaseline smear group.The result of the PCR showed that expression level of VEGF and HIF-1α in the 5 ％ fer ulic acid group was similar to that in the rb bFGF group and the vaseline smear group,but was obviously more than that of the ischemic control group and the vaseline smear group (P ＜ 0.05).Conclusions Ferulic acid can promote angiogenesis by increasing VEGF and HIF-1α which are closely related to angiogenesis and then promote the healing of chronic wounds.

Clinical research about the correlation between Fas、FasL protein and breast cancer / 中国现代普通外科进展

Objective:To investigate the clinical significance of the expression of Fas and FasL in breast cancer tissue and their relationship with the prognosis of breast cancer.Methods:Immunohistochemical technique was used to detect protein expression proportion and the level of Fas and FasL in 60 cases of breast cancer and 10 cases of benign breast tumor tissues.the experimental data were analyzed using semi-quantitative count and SPSS22.Results:The positive rate of Fas,FasL in breast cancer and benign breast tumor tissues were 78.33％ (47/60),80％ (8/10) and 95％ (57/60),70％(7/10),the positive rate of Fas protein in breast cancer tissues was higher than that of benign breast tumors,the positive rate of FasL protein in breast cancer was lower than that in benign breast tumor tissue.Fas、FasL protein expression were no significantly correlated with that of breast cancer staging,age,molecular typing,HER-2 and axillary lymph node status.but The strong expression of Fas,FasL protein were significantly correlated with that of the axillary lymph node status and the expression of ki-67.Conclusion:The strong expression of Fas,FasL protein may be associated with breast cancer metastasis and progress,and they could be as indicators of the evaluation of prognosis of breast cancer.

Treatment for mentalis scars with expanded skin flaps / 中华医学美学美容杂志

Objective To investigate the cosmetic outcome of treatments for mentalis scars with expanded skin flaps.Methods From the experiences of past 26 cases in our department,we summarised the technique for treating the mentalis scars with expanded skin flaps.For simple mentalis scars or localized inferior facial scars,the mentalis,bottom jaw or facial skin were expanded and the expander kept superior to the neck-jaw angle.Otherwise the expander would only fill the angle and the expanding efficiency was reduced.For severe mentalis,neck or facial scars without extra normal treating skin,expanded deltopectoral flaps were chosen to cover the wound after cicatrectomy with pedicles which were cut 3 weeks later.Results All the local ordistant expanded flaps survived successfully in the 26 cases with optimistic outcomes.Conclusions Application of local or distant expanded flaps is a useful technique for mentalis scars treatment.

Evaluation of the effects of pulse high-volume hemofiltration in patients with severe sepsis: a preliminary study.

OBJECTIVES: The aim of this study was to evaluate the effects of pulse high-volume hemofiltration (PHVHF) in patients with severe sepsis. METHODS: Twenty-two patients with severe sepsis admitted to XiJing hospital between January 2009 and January 2010 were included in the present study. Patients were randomly divided into the control group (conventional treatment) and the PHVHF group. Patients in the PHVHF group received 72 h of PHVHF treatment in addition to conventional treatment after admission. PHVHF was conducted as follows: HVHF 85 ml/kg per hour for 6 h followed by continuous venovenous hemofiltration 35 ml/kg per hour for 18 h with an AN69 membrane. The hemofilter was replaced every 24 h and PHVHF was performed with 250 to 300 ml/min blood flow rate. The blood samples were taken to measure the changes of plasma cytokines (TNF-α, IL-1, IL-4, IL-6 and IL-10). RESULTS: With 72 h of PHVHF treatment, there was an improvement in clinical features and hemodynamics variables in PHVHF-treated patients. All plasma cytokines after PHVHF treatment were significantly lower than those at the start of PHVHF treatment (p<0.05). In contrast, there was no significant change in control patients. CONCLUSIONS: Our findings suggest that PHVHF is a feasible adjuvant modality in the treatment of patients with severe sepsis. With the application of PHVHF treatment, plasma cytokines are effectively removed. Considering the lower cost and better feasibility than continuous high-volume hemofiltration (CHVF), PHVHF shows promising prospects for the future.

The impacts of continuous veno-venous hemofiltration on plasma cytokines and monocyte human leukocyte antigen-DR expression in septic patients.

The aim of this study was to investigate the impacts of continuous veno-venous hemofiltration (CVVH) on plasma cytokines and monocyte human leukocyte antigen-DR (HLA-DR) expression and to evaluate the relationship between them during CVVH treatment in septic patients. Forty septic patients were enrolled in this study. They were randomly divided into control group (who received conventional treatment, n=20) and CVVH group (who received conventional treatment and CVVH treatment, n=20). The blood samples were taken to measure the changes of plasma cytokines (IFN-gamma, TNF-alpha, IL-1, IL-2, IL-4, IL-6, IL-10 and IL-13) and HLA-DR expression on monocytes. After CVVH treatment, the plasma levels of IFN-gamma, IL-1, IL-2, IL-4, IL-10 and IL-13 in septic patients were markedly decreased (P<0.05), while the levels of TNF-alpha and IL-6 were only lowered to some extent without significant difference (P>0.05). HLA-DR expression on monocytes improved in CVVH treated patients (P<0.05). No matter pre-treatment or post-treatment of CVVH, there was a negative correlation between plasma IL-10 and monocyte HLA-DR expression (P<0.05). In contrast, no obvious change was shown in control patients. Our findings suggest that CVVH is effective in removal of many plasma cytokines and in improvement of monocyte HLA-DR expression in septic patients.

Expanded deltopectoral flaps for treatment of cervical cicatricial contracture / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the application of expanded deltopectoral flaps for treatment of cervical cicatricial contracture.</p><p><b>METHODS</b>The cervical cicatricial contracture was corrected in 18 cases with unilateral expanded deltopectoral flaps and 2 cases with bilateral expanded deltopectoral flaps. The size of scar ranged from 8 cm x 5 cm to 12 cm x 13 cm. The size of the unilateral expanded deltopectoral flaps ranged from 9 cm x 16 cm to 12 cm x 18 cm. The defects in donor sites were closed directly. The infraclavicula incision was designed. The flaps were delayed 3 weeks after flap transfer. The pedicle was cut off 4 weeks later.</p><p><b>RESULTS</b>From 2007 to 2009, 20 cases with cervical cicatricial contracture were treated with expanded deltopectoral flaps. All the flaps were survived. 6 cases were followed up for 6 months with satisfactory results in 5 cases and conspicuous scar in 1 case.</p><p><b>CONCLUSIONS</b>Expanded deltopectoral flap is very suitable for large size of cervical cicatricial contracture.</p>

Repair of inframammary scars with expanded skin flaps / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate suitable treatment method for contracture of inframammary scars.</p><p><b>METHODS</b>Nine female patients with contracture of inframammary sear hospitalized in our hospital from July 2000 to July 2007 were subjected to skin expansion around the breast. The sites of incisions were mainly located on the inframammary scars. The expanders were placed around the breast and middle chest near the sternum. On the lateral side of chest, the expander should be inserted at the site parallel to upper level of the breast. The expanders should be placed under deep fascia and superficial to the gland. At II stage of operation, the scars were excised and the subcutaneous tissues should be thoroughly loosened to assure that the soft tissue and mammary gland would be restored to its anatomical position. Expanded skin was then designed as advancement or transposition flaps to repair the defects, or effects were closed with suturing.</p><p><b>RESULTS</b>Blood circulation disturbance occurred at the tip of a flap in one patient, with the size of 4.0 cm x 3.0 cm, and the resulting wound healed after skin grafting. Flaps in the other 8 patients survived, and the wounds healed satisfactorily. Nipples and mammary areola were successfully restored to the anatomical positions. Three patients were followed up for 6 months to 2 years, and the result was satisfactory.</p><p><b>CONCLUSIONS</b>Expanded flap is feasible for repairing contracture of inframammary scar and with good result.</p>