Lesson learned from China regarding use of personal protective equipment.

BACKGROUND: In Wuhan, China, in December 2019, the novel coronavirus was detected. The virus causing COVID-19 was related to a coronavirus named severe acute respiratory syndrome coronavirus (SARS-CoV). The virus caused an epidemic in China and was quickly contained in 2003. Although coming from the same family of viruses and sharing certain transmissibility factors, the local health institutions in China had no experience with this new virus, subsequently named SARS-CoV-2. METHODS: Based on their prior experience with the 2003 SARS epidemic, health authorities in China recognized the need for personal protective equipment (PPE). Existing PPE and protocols were limited and reflected early experience with SARS; however, as additional PPE supplies became available, designated COVID-19 hospitals in Hubei Province adopted the World Health Organization guidelines for Ebola to create a protocol specific for treating patients with COVID-19. RESULTS: This article describes the PPE and protocol for its safe and effective deployment and the implementation of designated hospital units for COVID-19 patients. To date, only 2 nurses working in China who contracted SARS-CoV-2 have died from COVID-19 in the early period of the epidemic (February 11 and 14, 2020). CONCLUSIONS: The lessons learned by health care workers in China are shared in the hope of preventing future occupational exposure.

Iron Uptake via DMT1 Integrates Cell Cycle with JAK-STAT3 Signaling to Promote Colorectal Tumorigenesis.

Dietary iron intake and systemic iron balance are implicated in colorectal cancer (CRC) development, but the means by which iron contributes to CRC are unclear. Gene expression and functional studies demonstrated that the cellular iron importer, divalent metal transporter 1 (DMT1), is highly expressed in CRC through hypoxia-inducible factor 2α-dependent transcription. Colon-specific Dmt1 disruption resulted in a tumor-selective inhibitory effect of proliferation in mouse colon tumor models. Proteomic and genomic analyses identified an iron-regulated signaling axis mediated by cyclin-dependent kinase 1 (CDK1), JAK1, and STAT3 in CRC progression. A pharmacological inhibitor of DMT1 antagonized the ability of iron to promote tumor growth in a CRC mouse model and a patient-derived CRC enteroid orthotopic model. Our studies implicate a growth-promoting signaling network instigated by elevated intracellular iron levels in tumorigenesis, offering molecular insights into how a key dietary component may contribute to CRC.

[Combining eyebrow and inferior palpebral margin incision for the facial rejuvenation in the upper eyelid and midface region].

Objective: To investigate a simple, minimally invasive and effective operative method for the facial rejuvenation in the upper eyelid and midface region. Methods: Blepharoplasty was combined with suspending orbicularis oculi muscle flap and fixing it on the periosteum underneath the eyebrow through eyebrow incision. Meanwhile, for midface rejuvenation, inferior palpebral margin incision was performed and prezygomatic interspace was separated completely under the orbicularis oculi muscle. The under-eye puffiness and tear trough deformity were corrected through releasing orbital fat, reposition and fastening orbital septum, and transposition of orbicularis oculi muscle flap. And the deep sulci nasolabialis and cheek anetoderma were relieved by dual lifting of malar fat pad and orbicularis oculi muscle flap. Follow-up was taken at the 1 week,3 months,6 months,1 year,2years and 3 years after operation. Each case was evaluated with postoperative effect, reprocessing time and postoperative complications and underwent photography. Results: From Feb.2010 to Oct.2014,190 patients (9 male,181 female, an average age of 49.03 ± 5.67 years) underwent this operation. Obvious improvement on the upper eyelid and midface region was achieved in all the patients after operation without serious or irreversible complication Conclusions: Combining eyebrow and inferior palpebral margin incision, through suspending the malar fat pad and orbicularis oculi muscle flap at the same time, as a simple, minimally invasive and reliable method, can strengthen the effect of the facial rejuvenation in the upper eyelid and midface region markedly.

[Prospective and comparative study of the double eyelid blepharoplasty with central minimal incision and with three minimal incisions].

OBJECTIVE: To compare the clinical effect of the double eyelid blepharoplasty with central minimal incision and with three minimal incisions. Methods: From Jul. 2010 to May 2012, 268 cases (Group A) received double eyelid blepharoplasty with central minimal incision, while 102 cases (Group B) underwent double eyelid blepharoplasty with three minimal incisions. Photos were taken immediately, and 1,2, 4, 8,12 weeks after operation. Operation time, recovery time and postoperative complications were evaluated and recorded. The operation time and recovery time were analyzed by Wilcoxon rank sum test. The postoperative complications were analyzed by chi square test. The satisfactory degree was analyzed by t test. RESULTS: The operation time in Group A was (25.63 ± 3.74) min, compared with that (29.90 ± 4.13) min in Group B (Z = -8.011, P <0.01). Meanwhile, the recovery time in Group A was shorter than that in Group B (Z = -15.887, P <0.01). The occurrence rate of postoperative complications,including hematoma,recurrence and scar hyperplasia in Group A was also lower than that in Group B. At the same time, the satisfactory degree in Group A was(97.302 ± 1.764), which was higher than that(88.628 10.880) in Group B (t = 12.650, P <0.05). CONCLUSIONS: The double eyelid blepharoplasty with central minimal incision, which is suitable for all cases except those who has serious blepharochalsais, has more advantages than double eyelid blepharoplasty with three minimal incisions.

[Transposition of orbital fat and orbicularis muscle flap over the orbital rim for correction of lower eyelid pouches complicated with lacrimal groove deformity].

OBJECTIVE: To introduce the experience in the treatment of lower eyelid pouches orbital rim. METHODS: An incision was made along the margin of lower eyelid and dissection was performed under the orbicularis muscle to expose the orbital septum and periosteum of lower orbital rim. The fat released from orbital septum was transposed just below the lower orbital rim and fixed on the periosteum. If lacrimal groove deformity was not corrected completely, the musculocutaneous flap, which may be excised beside the incision, was kept to correct the deformities further with only the muscle portion. RESULTS: 72 cases with lower eyelid pouches complicated with lacrimal groove deformities were treated with transposition of orbital fat and orbicularis muscular flaps. Satisfactory results were achieved in all the patients after a follow-up period of 3-6 months. CONCLUSION: It is an effective and feasible technique to correct lacrimal groove deformities with transposition of orbital fat and orbicularis muscular flaps.

[Preliminary clinical study on the treatment of severe infantile hemangioma with high-dose propranolol in China].

OBJECTIVE: To investigate the clinical results of the treatment of severe infantile hemangioma with high-dose propranolol in Chinese. METHODS: 56 cases with severe infantile hemangioma were treated with propranolol. Clinical evaluation, electrocardiography, and experimental examination of liver function and heart function were performed before treatment. The daily dose of propranolol was increased from 1 mg/kg at the first day to 1.5 mg/kg at the second day, and to 2 mg/kg at the third day. The propranolol was given twice a day. The treatment was lasted for six months. The patients were visited every month. RESULTS: The lesion color was changed after 2-4 days of treatment in all the cases. All the lesions were dramatically improved after one month of treatment. The ulceration were healed, except one case. Until now, complete regression was achieved in 10 cases and marked improvement in 46 cases. Side effects were happened in 3 cases, including one case of abnormal liver function, one case of CK-MB increase and one case of continuous increase of CK-MB, LDH, ALT, GGT. CONCLUSIONS: High-dose Propranolol is very effective in the treatment of infantile hemangioma with minor side effects and short disease period. It might he used as the first-line treatment for infantile hemangioma.

[Monobloc distraction osteogenesis and cranial vault remodeling in a pediatric patient with severe Crouzon's syndrome].

OBJECTIVE: To report the treatment of a case of severe Crouzon's syndrome using monobloc distraction osteogenesis and cranial vault remodeling. METHODS: Through intra-and extra-cranial approach, monobloc osteotomy was performed and external distractor was placed. Distraction began on the 7th postoperative day at a rate of 1 mm a day, two times a day. The distractor removed after consolidation for 4 months. RESULTS: The distraction distance attained 20 mm. The exophthalmos and cross bite were corrected completely. The severe obstructive apnea improved markedly. CONCLUSIONS: Monbloc distraction osteogenesis and cranial vault remodeling are effective and safe procedure for Crouzon's syndrome.

[Research and clinical application of computer-aided design of craniofacial prosthesis using mirror technique].

OBJECTIVE: To explore the feasibility of creating a 3D-CAD model of craniofacial prostheses through mirror technique to repair the unilateral craniofacial defects and restore craniofacial symmetry. METHODS: Patients with unilateral craniofacial defects underwent spiral CT scanning. CAD3-D image was reconstructed ad 3-D CAD model of craniofacial prosthesis was created with mirror technique, Boolean operation and rapid prototyping technique. Then the prosthesis made of bioactive artificial bone was made through plaster cavity block. RESULTS: 15 cases were treated with no complications. Good symmetry was achieved after operation. CONCLUSIONS: Designing the craniofacial prosthesis with mirror technique guarantees excellent functional and cosmetic results for repairing the unilateral craniofacial defects.