[Clinical application of Visual throat forceps in the removal of hypopharyngeal foreign body].

Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.

[Clinical application of mandibular osteomuscular flap pedicled with temporalis to repair maxillary bone defect].

OBJECTIVE: To evaluate the clinical effect of mandibular osteomuscular flap pedicled with temporalis to repair maxillary defect. METHODS: From March 2008 to May 2010, ten cases of maxillary defects resulted from malignant tumor resection were treated with mandibular osteomuscular flap pedicled with temporalis. Ten cases of malignant tumor included six cases of Squamous cell carcinoma,one case of duct carcinoma, osteosarcoma, chondrosarcoma and malignant melanoma. One case was repaired by mandibular osteomuscular flap only, nine cases were repaired by mandibular osteomuscular flaps combined with other soft tissue flaps. RESULTS: All the 10 mandibular osteomuscular flaps survived completely with no complication. The patients were followed up for 12 to 36 months, with an average of 18 months. Satisfactory appearance and complete functional restoration were achieved except for one case of chondrosarcoma recurrence. CONCLUSIONS: The mandibular osteomuscular flap pedicled with temporalis is safe and easily performed with less complication. It is an ideal method for repairing the maxillary defect.

[Applied anatomy of superficial inferior epigastric artery flap].

OBJECTIVE: To provide the anatomical basis for the application of the superficial inferior epigastric artery flap. METHODS: Ten cadavers which were immersed in formalin less than 6 months and were perfused by red latex were used in this study. There were 8 males and 2 females with an average age of 58 years (range, 35-78 years). The origin, course, branch, distribution, diameter, pedicle length, and neighbour of superficial inferior epigastric artery and vein were observed in the 2 sides of inguinal region. RESULTS: In these series of 10 cadaver (20 sides) dissections, the superficial inferior epigastric artery was identified in 18 sides, which average caliber was 1.48 mm with a mean vascular pedicle length of 4.80 cm. In 11 sides, the superficial inferior epigastric artery arose as part of a common trunk with one or more other vessels; in other 7, it originated from the femoral. There were 4 branch modes of superficial inferior epigastric artery: single trunks (5 sides), double ramification (3 sides), single lateral ramification (7 sides), and single medial ramification (3 sides). The superficial inferior epigastric vein was observed in 20 sides, which average caliber was 2.33 mm with a mean sides pedicle length of 5.45 cm. In 8 sides, the venous drainage was as an individual vein; in 12 sides, both patterns were observed (a pair of venae comitantes and an individual vein). CONCLUSION: The inferior epigastric artery flap can be applied to microsurgical flap transfer, potentially in breast reconstruction, phalloplasty, reconstruction of head, neck and four limbs defects.

[Anatomic study of mandibular bone flap pedicled with temporal muscle for midface bone defect].

OBJECTIVE: To study the anatomy of mandibular bone flap pedicled with temporal muscle for midfacial bone defects. METHODS: The shape and blood supply of the temporal muscle and mandibular ramus, as well as their relationship, were observed and measured in 30 sides of adult head specimens. RESULTS: The temporal muscle has a fan-shaped main portion, then is scattered into three bundles as anterolateral, anteromedial, posterior bundles, which end respectively at anterior border of ramus, the temporal ridge and posterior portion of coronoid process. Then the muscle goes downward until it reaches the distal side of the third medial surface molar and attaches the 3/4 of medial surface of anterior portion of ramus. The blood supply of temporal muscle includes the medial temporal artery with external diameter of (0.76 +/- 0.20) mm, the anterior deep temporal arteries with external diameter of (0.79 +/- 0.21) mm, posterior deep temporal arteries with external diameter of (0.98 +/- 0.64) mm, the accessory deep temporal artery formed by many little branches. The anterior part of ramus is supplied by the periosteal arteries and the bony perforator of the deep temporal arteries. Rectangular ramus of mandible was divided into anterior portion and posterior portion by the line linking the lowest point of mandibular notch, mandibular foramen and mandibular canal. Anterior portion can supply a bone flap with a size of (46.67 +/- 6.85) mm x (17.98 +/- 2.64) mm x (11.49 +/- 0.99) mm. CONCLUSIONS: The mandibular bone flap pedicled with temporal muscle has a reliable blood supply and abundant bone volume. It is feasible to design a mandibular bone flap pedicled with temporal muscle for midfacial bone defect.

Implementation of ISBT 128 in China.

BACKGROUND: In 2001, the blood collection agencies of Zhejiang Province adopted a unified information system, but when a blood product was transferred from the collection and processing facility inventory to some other inventories, because of lacking the unique identifying ability between facilities, the numbers might be overlapped. The exchange of blood units between agencies needed change of labels, and it was very complicated. The SARS outbreak in 2003 made this problem more prominent. Therefore, we decided to redevelop a new information system based on ISBT 128 to solve this problem. STUDY DESIGN AND METHODS: We registered with ICCBBA and obtained the technical documentation and database. We requested the new product description code from ICCBBA and properly adjusted the incompatibility between ISBT 128 and the national standards. We redesigned the information system and labels and validated some related equipment and the laboratory information system. RESULTS: In May 2005, we completed the development of the new information system based on ISBT 128, and by the end of 2005, all the blood collection agencies of the Zhejiang Province began to use ISBT 128. As a result, the product information in blood collection agencies of Zhejiang Province can be shared, and the exchange of blood products between agencies became safe and rapid. It was highly praised by the nation's Ministry of Health. CONCLUSIONS: ISBT 128 was successfully implemented in Zhejiang Province.

Development and evaluation of real-time loop-mediated isothermal amplification for hepatitis B virus DNA quantification: a new tool for HBV management.

BACKGROUND: Accurate quantitation of hepatitis B viral load is a critical aspect in screening and monitoring HBV infection. OBJECTIVES: We used loop-mediated isothermal amplification (LAMP) to develop a real-time fluorogenic (RtF-LAMP) protocol to quantitate HBV DNA. Quantitative analysis was obtained by measuring time-to-positive (TTP), a biomarker similar to cycle threshold (Ct) in real-time PCR. STUDY DESIGN: Sensitivity, specificity, reproducibility, and dynamic range for RtF-LAMP were evaluated using molecular and biological standards. Four hundred and two patient samples were then used to compare the performance of RtF-LAMP to a commercial real-time PCR assay (DaAn Gene Co, China). RESULTS: The lower detection limit (LDL) of RtF-LAMP by Probit analysis at the 95% detection level was 210 copies/ml, and the dynamic range was 8 orders of magnitude. The conversion factor for results obtained with the RtF-LAMP assay was 1 IU/ml equals to 4.4 copies/ml. Coefficients of variation (CV) reflected low intra-assay and inter-assay variability (4.24-12.11%). In a large number of serum samples, there was excellent an correlation between RtF-LAMP and real-time PCR (R(2)=0.96). There was a good agreement between the two tests except at the detection cutoff of the real-time PCR assay. CONCLUSION: Our RtF-LAMP protocol appears to be precise, accurate and rapid. It could be a valuable tool for the detection of HBV in large clinical and epidemiological studies.

[Research on Zhejiang blood information network and management system].

This research was aimed to develop the first level blood information centralized database and real time communication network at a province area in China. Multiple technology like local area network database separate operation, real time data concentration and distribution mechanism, allopatric backup, and optical fiber virtual private network (VPN) were used. As a result, the blood information centralized database and management system were successfully constructed, which covers all the Zhejiang province, and the real time exchange of blood data was realised. In conclusion, its implementation promote volunteer blood donation and ensure the blood safety in Zhejiang, especially strengthen the quick response to public health emergency. This project lays the first stone of centralized test and allotment among blood banks in Zhejiang, and can serve as a reference of contemporary blood bank information systems in China.

[Retrospective study on HIV infection among blood donors in Zhejiang Province over 11-year period (1993 - 2004)].

To determine HIV prevalence among blood donors in Zhejiang Province from 1993 to 2004 years, almost 6,600, 000 blood donors information were collected and analyzed. Every sample was screened for markers of HIV-1 and HIV-2 by using commercially available ELISA kits twice, and Western blot for confirmation if positive or suspicious result appeared. The results indicated that during the study period, prevalence rate of HIV infection was 0.85/1000 donors (0.085%), with the rising tendency from 1:600000 in 1995 to 1:37500 in 2004. The prevalence of HIV infection in Zhejiang donors was significantly lower than that in donors of other provinces, prevalence of HIV infection in male was higher than that in female. In recent years, the prevalence of HIV in blood donors was obviously increased, but the difference among various populations began to reduce. It is concluded that in a low HIV prevalence area like Zhejiang province where no obvious AIDS occurred, risk for the expansion of the HIV epidemic was on the increase. Screening procedure used in transfusion services nowaday is reliable, but a comprehensive approach is required to make the blood more safe.