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Objective:To compare the pros and cons of harvesting ear cartilage through anterior and posterior auricular approaches during rhinoplasty.Methods:From January 2017 to December 2018, 63 patients with otochondral rhinoplasty in our hospital were enrolled in this study, 60 were female and 3 were male; the average age was 31.6 years (range, 18 to 43) . They were randomly divided into anterior auricular approach group with 32 cases (64 sides) and posterior auricular approach group with 31 cases (62 sides). Surgical duration, complications and postoperative scar of the two methods were analyzed.Results:The average time for harvesting the ear cartilage through posterior auricular approach and anterior auricular approach was (20.8±1.7) min and (12.6±1.1) min, respectively ( P<0.01). The overall complication rate was 15.6% for posterior auricular approach group and 4.8% for anterior auricular approach group. The wound healed well in both groups, and there was no significant difference in postoperative scar between the two groups during an average 13 months follow-up period. Conclusions:While both the anterior and the posterior auricular approaches present with similar inconspicuous scarring, the use of anterior auricular approach alone to harvest ear cartilage during rhinoplasty provides both the surgeons and the patients with easier access, shorter surgical duration, and fewer complications. Hence, we believe that the anterior auricular approach possesses greater advantages than the posterior auricular approach.
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Objective@#The purpose of this study is to systematically review the literature about surgical management of lymphedema, to provide recomendations for the surgical treatment plan of the disease.@*Methods@#Cochrane Library and EMBASE databases were searched from January 1st, 2007 to October 1st, 2017 for the literature related to the surgical treatment of lymphedema. Data were extracted from clinical studies matching our inclusion criteria. Meta-analysis was performed with R 3.4.2.@*Results@#71 studies were included, out of which 4 studies described were excision, 9 were liposuction, 33 were lymphvenous anastomosis(LVA), 23 were vascularized lymph node transfer(VLNT) and 5 were combined therapy. The excess volume reduction were averaged 96.86%(95%CI: 87.38%—106.33%, I2=0%)for liposuction, 34.64%(95%CI: 19.80%—49.47%, I2=72%)for LVA, 36.85%(95%CI: 12.40%—61.30%, I2=81%) for VLNT.@*Conclusions@#With further understanding of the pathophysiology of lymphedema and development of radiologic and surgical technique, surgical treatment has the potential to play an important role in lymphedema complex management.
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Objective To analyze the effect of perioperative blood transfusion in orthopedic surgery.Methods A total of 201 patients who underwent an orthopedic surgery in our hospital in October 2015 to September 2016 were reviewed.Hemoglobin concentrations,hematocrit,postoperative hospital stay,infection and other related data were analyzed.Results 90 patients were transfused with blood and in 111 patients were not during orthopedic surgery (massive blood transfusion group including 17 cases;non massive blood transfusion group including 94 cases).Hemoglobin concentrations of transfusion group (103.09±16.37)g/L was lower than the non transfusion group (115.79± 13.68)g/L before liying hospital,postoperative hospitalization time of transfusion group (12.012±8.36) was longer than that of non transfusion group (16.14 ± 10.47)days.Postoperative infection rate in non transfusion group was 1.11％,and in transfusion group was 15.32％,in massive transfusion group is 52.94％.Conclusion Perioperative blood transfusion is not conducive to the recovery of hemoglobin level patients in orthopedic surgery,prolong hospital stay and increase the rate of infection after surgery.Perioperative blood transfusion makes it difficult to support the outcome of the disease
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Objective To evaluate the effect of morphine on the growth of subcutaneous tumor of human gastric cancer cells in nude mice.Methods Thirty SPF male BALB/C nude mice,aged 4-5 weeks,weighing 15-20 g,in which the model of subcutaneous tumor of human gastric cancer cell line MGC-803 was established,were randomly divided into 3 groups (n=10 each) using a random number table:control group (group C),normal saline group (group N),and morphine group (group M).The mice in group C received no treatment.Morphine 20 mg/kg was intraperitoneally injected once a day for 14 consecutive days in group M,while normal saline 1.5 ml/kg was given instead of morphine in group N.The caliper was used to measure the tumor size every 2 days starting from 3 days after beginning of administration,and the relative tumor volume was calculated.The nude mice were sacrificed on 15th day,and the tumor tissues were obtained for determination of nuclear factor-kappa B activity and Bcl-2 and Bax protein and mRNA expression by real-time reverse transcriptase polymerase chain reaction and Western blot.Results Compared with group C,the relative tumor volume was significantly decreased,the activity of nuclear factor-kappa B in tumor tissues was significantly decreased,the expression of Bcl-2 protein and mRNA was significantly down-regulated,and the expression of Bax protein and mRNA was significantly up-regulated at each time point in group M (P＜0.05),and no significant change was found in each parameter mentioned above in group N (P＞0.05).Conclusion Morphine can inhibit the growth of subcutaneous tumor of human gastric cancer cells in nude mice,and the mechanism is associated with promotion of apoptosis in tumor cells.
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Objective To evaluate the effect of fentanyl on the expression of vascular endothelial growth factor A (VEGF-A) and matrix metallopeptidase-9 (MMP-9) in the subcutaneous tumor of human gastric cancer in nude mice.Methods Thirty SPF male BALB/C nude mice,aged 4-5 weeks,weighing 15-20 g,in which the model of subcutaneous tumor of human gastric cancer cell line MGC-803 was established,were randomly divided into 6 groups (n =5 each) using a random number table:control group (C group),normal saline group (NS group) and fentanyl 0.05,0.10,0.20 and 0.40 mg/kg groups (F1-4 groups).The mice in group C received no treatment.Fentanyl 0.05,0.10,0.20 and 0.40 mg/kg were intraperitoneally injected once a day for 14 consecutive days in F1 4 groups,respectively,while the equal volume of normal saline 1.5 ml/kg was given instead of fentanyl in group NS.The nude mice were sacrificed on 1 day after the end of administration,and the tumor tissues were obtained for examination of the ultrastructure of subcutaneous tumor (with a transmission electron microscope) and for detection of the expression of VEGF-A and MMP-9 (by immunohistochemistry and Western blot) and expression of VEGF-A and MMP-9 mRNA (by real-time reverse transcriptase polymerase chain reaction).Results No abnormality in the morphology of the subcutaneous tumor cells was observed in C and NS groups.The swollen nucleus,chromatin margination,nuclear fragmentation and apoptotic bodies were found in the subcutaneous tumor cells in F1-4 groups.Compared with group C,the expression of VEGF-A and MMP-9 protein and mRNA was significantly down-regulated in F1-4 groups (P＜0.05),and no significant change was found in each parameter mentioned above in group NS (P＞0.05).There was no significant difference in the expression of VEGF-A and MMP-9 protein and mRNA among F1-4 groups (P＞0.05).Conclusion The mechanism by which fentanyl inhibits the growth and metastasis of subcutaneous tumor cells of human gastric cancer is related to down-regulation of VEGF-A and MMP-9 expression in nude mice.