Application of trifoliate flap design of radial forearm flap in reconstruction of defects after mouth floor cancer resection / 中华肿瘤杂志

Objective: To evaluate the effect of trifoliate flap design of radial forearm flap in reconstruction of defects after mouth floor cancer resection. Methods: From June 2016 to December 2019, 12 patients with defect after resection of mouth floor cancer were treated with trifoliate flap design of radial forearm flap. All of these patients were T2 stage, included 9 well-differentiated squamous cell carcinoma (SCC) and 3 moderate differentiated SCC. The defect size ranged from 8.0 cm×6.0 cm to 5.0 cm×4.5 cm after resection of tumor and neck dissection. All defects were repaired with trifoliate flap design of radial forearm flap. The flap size ranged from 8.0 cm×2.0 cm to 4.0 cm×1.5 cm, the donor site was sutured directly on Z plasty. Results: All flaps completely survived well. Both the wound and the donor site were stage Ⅰ healing. With the average follow-up of 38.6 months, the swallowing and speech function were satisfactory. Conclusions: Trifoliate flap design of radial forearm flap can effectively repair the postoperative defect of mouth floor cancer, and the donor site can be directly sutured on Z plasty. This technique can avoid forearm scar caused by skin grafting and the formation of the second donor site.

Correlation of Betel Quid with Oral Cancer from 1998 to 2017: A Study Based on Bibliometric Analysis / 中华医学杂志(英文版)

Background@#Betel quid chewing has been a major risk factor for oral cancer (OC) in southern China. This study aimed to analyze the scientific publications on the relationship between betel quid chewing and OC and construct a model to quantitatively and qualitatively evaluate pertinent publications from 1998 to 2017.@*Methods@#The publications from 1998 to 2017 were retrieved from the Web of Science Core Collection database. Microsoft Excel, Thomson Data Analyzer, VOSviewer, and CiteSpace software were used to analyze the publication outcomes, journals, countries/regions, institutions, authors, research areas, and research frontiers.@*Results@#A total of 788 publications on the relationship between betel quid chewing and OC published until October 25, 2017, were identified. The top 4 related journals were Journal of Oral Pathology Medicine, Oral Oncology, Plos One, and International Journal of Cancer. The top five countries engaged in related research included China, India, the United States, the United Kingdom, and Malaysia. The corresponding disciplines, such as oncology, oral surgery, pathology, environmental and occupational health, and toxicology, were mainly concentrated in three disciplines. The subject terms squamous cell carcinoma, OC, betel quid, expression, oral submucous fibrosis, India, and p53 ranked first among research hotspots. The burst terms squamous cell carcinoma, OC, betel quid, and expression ranked first in research frontiers.@*Conclusions@#Research in this area emphasized hotspots such as squamous cell carcinoma, OC, oral submucosal fibrosis, betel quid, and tobacco. The annual number of publications steadily decreased from 1998 to 2017, with a lack of a systematic study from interdisciplinary perspectives, inadequate pertinent journals, limited regions with the practice of betel quid chewing, and insufficient participation of researchers, which indicate that as the prevalence of OC increases, particularly in China, research in this area warrants further expansion.

Exploiture and application of an internet-based Computation Platform for Integrative Pharmacology of Traditional Chinese Medicine / 中国中药杂志

Recently, integrative pharmacology(IP) has become a pivotal paradigm for the modernization of traditional Chinese medicines(TCM) and combinatorial drugs discovery, which is an interdisciplinary science for establishing the in vitro and in vivo correlation between absorption, distribution, metabolism, and excretion/pharmacokinetic(ADME/PK) profiles of TCM and the molecular networks of disease by the integration of the knowledge of multi-disciplinary and multi-stages. In the present study, an internet-based Computation Platform for IP of TCM(TCM-IP, www.tcmip.cn) is established to promote the development of the emerging discipline. Among them, a big data of TCM is an important resource for TCM-IP including Chinese Medicine Formula Database, Chinese Medical Herbs Database, Chemical Database of Chinese Medicine, Target Database for Disease and Symptoms, et al. Meanwhile, some data mining and bioinformatics approaches are critical technology for TCM-IP including the identification of the TCM constituents, ADME prediction, target prediction for the TCM constituents, network construction and analysis, et al. Furthermore, network beautification and individuation design are employed to meet the consumer's requirement. We firmly believe that TCM-IP is a very useful tool for the identification of active constituents of TCM and their involving potential molecular mechanism for therapeutics, which would wildly applied in quality evaluation, clinical repositioning, scientific discovery based on original thinking, prescription compatibility and new drug of TCM, et al.

Surgical management for residual or recurrent diseases in the neck after radiotherapy in nasopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the surgical managements for residual or recurrent diseases in the neck after radiotherapy in nasopharyngeal carcinoma.</p><p><b>METHODS</b>Seventy-eight cases of neck masses (39 cases for unilateral residual diseases, 9 for bilateral residual diseases and 30 for recurrent diseases) after radiotherapy in nasopharyngeal carcinoma who were treated surgically between January 1990 and December 2005 were retrospectively analyzed. There were 56 males and 22 females. Their ages ranged from 28 to 65 years (median 41 years). There were 27 patients with skin involvement. After preoperative imaging assessment, 17 patients whose common carotid arteries or internal carotid arteries were difficult to separate routinely attained the carotid balloon occlusion test which confirmed that 15 cases of cerebral arterial circle open to compensation, however, two cases of poor compensation. Surgical procedures included expanded neck mass resection (21 cases), unilateral radical neck dissection (49 cases) and bilateral radical neck dissection (8 cases). Of them 5 patients were with unilateral internal carotid artery resection. Neck defects were repaired with pectoralis major muscle flaps (15 cases), free anterolateral femoral skin flaps (9 cases) and trapezius muscle flaps (3 cases). Of the 78 patients, 13 with microscopic positive diseases and 2 with residual diseases in internal carotid artery walls underwent postoperative radiotherapy, with the doses of 45 to 50 Gy.</p><p><b>RESULTS</b>All patients were closely followed-up more than 5 years. Three- and five-year survival rates were 46.2% and 28.3% respectively. Neck defects were successfully repaired with skin flaps immediately after resecting diseases in 27 cases, only one patient with delayed healing. Of 51 patients without skin flap repair, neck wounds healed successfully in 45 patients and with delayed healing in 6 patients. Pathological positive rates of lymph nodes located in the level I, II, III, IV and V were 10.5%, 61.4%, 10.5%, 1.8% and 28.1% respectively.</p><p><b>CONCLUSIONS</b>Preoperative balloon occlusion test is required to assess the function of Willis' ring before determining ligation or resection of internal carotid artery. Residual or recurrent diseases commonly exist in level II, VA and III, which should be included in neck dissection. Pectoralis major muscle flap and free anterolateral femoral skin flap are recommended for the repair of neck defect.</p>

Management of thyroid goiters invading mediastinum and thoracic cavity / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatments of thyroid goiters invading mediastinum and thoracic cavity.</p><p><b>METHODS</b>Seventy-eight cases of thyroid goiters invading mediastinum and thoracic cavity and undergoing surgery from 1995 to 2005 were reviewed. There were 22 males and 56 females and their age ranged from 45 years to 78 years with a median age of 59 years. According to the classification of intrathoracic thyroid goiters, there were 50 cases in Class I, 20 cases in Class II and 8 cases in Class III. In these patients, 38 cases suffered from dyspnea at degree I and 20 cases at degree II. Of the patients, 71 underwent thyroidectomy through neck approach and 7 underwent thyroidectomy by a combined approach of neck incision plus sternotomy or lateral thoracotomy. Tracheal defects in 4 cases and esophageal defects in 3 cases were repaired. Postoperative residual diseases were found in tracheoesophageal wall (5 cases) and mediastinum (6 cases). Eleven patients received postoperative radiotherapy and 18 underwent (131)I treatment. No case died of operation and no case with wound infection.</p><p><b>RESULTS</b>The time of follow-up was 60 - 180 months with a median of 110 months. Three patients lost follow-up. Dyspnea in 58 cases were improved after operation. Three of 49 patients with nodular goiters died from cardiocerebrovascular diseases. Of 29 patients with thyroid papillary carcinoma, 2 died from lung metastasis and 3 died from neck relapse. Five-year survival rate was 75.0% in the patients with thyroid cancer.</p><p><b>CONCLUSIONS</b>Most of thyroid goiters invading mediastinum and thoracic cavity can be completely resected via neck approach, but a combined approach of neck incision plus sternotomy or lateral thoracotomy may be used in some cases with malignant goiters to dissect the diseases completely. Postoperative external beam radiotherapy are required for the residual diseases. (131)I may be considered in high-risk differentiated thyroid carcinoma cases.</p>

Mitochondrial function score combined with Gleason score for predicting the progression of prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the mitochondrial function score in combination with Gleason score in predicting the progression of prostate cancer.</p><p><b>METHODS</b>This study included twenty 58-79 (70.1 +/- 1.2) years old patients with prostate cancer treated by radical prostatectomy. The epithelioglandular mitochondrial function scores of the patients were obtained under the transmission electron microscope and assessed according to Flameng grading. Meanwhile, their Gleason scores were analyzed and, based on the scores, the patients were divided into Groups I (Gleason score: 2 -4) and II (Gleason score: 5 -7).</p><p><b>RESULTS</b>The mitochondrial function score of Group I was significantly different from that of Group II (4.0 +/- 0.8 versus 2.3 +/- 0.6, P < 0.05), with a negative correlation with the Gleason score (r = -0.793, P < 0.05). One year follow-up showed a significantly lower mortality in Group I (0/8) than in Group II (6/12) (P < 0.05).</p><p><b>CONCLUSION</b>Mitochondrial dysfunction exists in prostate cancer patients, particularly in those with higher malignancy. The mitochondrial function score combined with Gleason score plays a valuable role in predicting the progression of prostate cancer.</p>

Improved experimental varicocele increases follicle-stimulating hormone and reduces inhibin B in rats / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of improved experimental left varicocele (ELV) on follicle-stimulating hormone (FSH) and inhibin B (InhB).</p><p><b>METHODS</b>ELV models were established by the improved method in 30 SD rats, and another 30 were included in a sham operation group as controls. Three months after the operation, the concentrations of the FSH and InhB were assayed by ELISA.</p><p><b>RESULTS</b>The concentration of FSH in the serum was significantly higher in the experimental group ([37.56 +/- 9.72] ng/ml) than in the control ([26.69 +/- 5.33] ng/ml) (P < 0.05), while that of InhB significantly lower in the former ([349.93 +/- 99.48] pg/ml) than in the latter ([768. 83 +/- 146.96] pg/ml) (P < 0.05).</p><p><b>CONCLUSION</b>Improved ELV can increase FSH and reduce InhB in rats, which may be associated with subfertility.</p>

Reinforcing the continent mechanism of continent cutaneous diversions by wrapped rectus abdominis muscle flap: a preliminary experimental study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Continent cutaneous diversion (CCD) has been widely used in almost any lower urinary reconstruction. We have been continually trying to modify this procedure because of the high complications rate, especially as they relate to the efferent tube. In this study, we reported a modified procedure with a tapered ileum wrapped by the rectus abdominalis flap (RAMF) and assessed the feasibility of this new technique to achieve urinary continence.</p><p><b>METHODS</b>A procedure in which two ileal segments were tapered and connected to a U-shaped reservoir was performed in ten dogs. A RAMF with its blood supply was wrapped around one of the tapered ileum. In control groups, the tapered ileum was brought to the abdominal skin. Urodynamic studies were conducted In the 1st, 3rd and 6th months post-operatively. The data of maximum inner pressure (MIP) and functional pressure length (FPL) in every group at each phase were recorded. Retrograde radiograms of the efferent limbs were performed before sacrifice.</p><p><b>RESULTS</b>MIP in the study group was significantly higher than that in the control group at each phase (P < 0.05). However, no significant differences in MIP or FPL were found in the study group between an empty and full reservoir. In the control group, MIP increased (P < 0.05) and FPL decreased significantly (P < 0.05) compared with an empty and full reservoir. Retrograde radiograms confirmed that efferent limbs were positioned straigh beneath the abdominal wall. Histological examination of the study group demonstrated a layer of striated muscle around the outside surface of the ileum.</p><p><b>CONCLUSION</b>The continent mechanism of tapered ileum can be enhanced by extra support from wrapped RAMF.</p>

Reconstructive surgery for male urethral stricture affects erectile function and sexual life quality / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the influence of reconstructive surgery for male urethral stricture on erectile function and sexual life quality.</p><p><b>METHODS</b>We analyzed retrospectively the clinical data of 326 male patients who underwent urethroplasty for urethral stricture in our department and evaluated their erectile function and sexual life quality.</p><p><b>RESULTS</b>A total of 172 groups of valid data were collected, with the mean follow-up of 28.5 months. The mean scores on IIEF-5 (P=0.002) and sexual life quality (P=0.026) were statistically significantly reduced after surgery. Erectile dysfunction was found in 88 (51.2%) of the patients after urethroplasty, as compared with 56 (32.6%) preoperatively.</p><p><b>CONCLUSION</b>The location of urethral stricture, surgical method and urethral stricture recurrence may affect the erectile function and sexual life quality of the patient, but both can be gradually improved with the time after urethroplasty.</p>

Etiopathogenesis and management of seminal vesicle enlargement / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the etiopathogenesis and management of seminal vesicle enlargement.</p><p><b>METHODS</b>Forty-six cases of seminal vesicle were selected, of which 36 were vesiculitis, treated by antibiotics through a catheter indwelt in the seminal vesicle for 1 week, 3 were cystic vesicular seminalis, given anti-inflammatory treatment by catheter administration and hydatid fluid inhalation, 1 was calculus at the orifice of the ejaculatory duct, taken out by transurethral resection of the verumontanum, 1 was polypous at the orifice of the verumontanum, removed by transurethral resection, 2 were posterior urethritis, treated by fulguration, and 3 were prostatic carcinoma, treated by radical prostatectomy and spermatocystotomy.</p><p><b>RESULTS</b>Hemospermia disappeared in 32 cases of vesiculitis during the 6-24 months follow-up, 4 cases experienced recurrent hemospermia 3 months after the treatment. No recurrence was observed in any other case of cystic vesicular seminalis, calculus, polypous, posterior urethritis and prostatic carcinoma.</p><p><b>CONCLUSION</b>Seminal vesicle enlargement has intricate etiopathogenesis, but can be treated with satisfactory results if managed properly.</p>

Free anterolateral thigh flap for repairing the defects of oral cavity and maxillofacial / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the outcomes following the tumor resection of oral cavity and maxillofacial and reconstruction with free anterolateral thigh flaps (ALT).</p><p><b>METHODS</b>Thirty one patients underwent ALT reconstruction following the tumor resection from Dec. 2004 to Dec. 2005. Among them, 17 cases were squamous cell carcinoma (SCC) of tongue, 6 cases of buccal SCC and 8 other malignant. The size of the ALT flaps ranged from 4 to 8 cm in width and 6 to 23 cm in length. Tracheotomy were performed for 4 cases intraoperatively.</p><p><b>RESULTS</b>The overall successful rate was 96.8%. Thirty cases survival no cancer, 1 case died of recurrent and no-controlled of lymph-node in 8 months after operation. Postoperative vessel thrombosis occurred in 3 flaps between 12 hours to 4 days after operation. Two of them were saved. The necrosis area of the third flap was 25%.</p><p><b>CONCLUSIONS</b>The ALT was benefit to repair the defects of oral cavity and maxillofacial, and the donor place was more easily hidden and didn't not influence the outlook and function; the important normal functional framing such as teeth and bone should be preserved; the pedicle of vessel could't be twisted during the procedure of reconstruction to avoid vein oppressed; the size of flap should be suitable to defects in order to avoid flaps being crowd and blood clot; tracheotomy was safe while repairing the defect of hard and soft palate. Reconstructive surgical procedures;</p>

Kidney transplantation improves spermatogenic function in patients with uremia / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the changes of testicular spermatogenic function after kidney transplantation.</p><p><b>METHODS</b>Thirty male patients with uremia underwent kidney transplantation. Semen analyses were made and sperm ultrastructural changes were studied before and after the operation.</p><p><b>RESULTS</b>Sperm viability, motility and movement velocity were significantly higher in the postoperative group than in the preoperative group [(70.08 +/- 2.86 vs (36.04 +/- 8.01)], [(76.15 +/- 3.75)% vs (39.27 +/- 4.14)%], [(16.80 +/- 1.11) microm/s vs (8.43 +/- 2.01)] micro/s, respectively (P < 0.01). Sertoli cell, acrosome and mitochondria structures inclined to normal after kidney transplantation.</p><p><b>CONCLUSION</b>Kidney transplantation can significantly improve spermatogenic function in patients with uremia.</p>

Replacement of artificial tracheal prosthesis by two-stage procedure with memory-alloy mesh / 中华外科杂志

<p><b>OBJECTIVE</b>To design an artificial trachea which can totally heal with the native trachea.</p><p><b>METHODS</b>Using memory-alloy mesh as the skeleton to construct an artificial trachea by two-stage operation. After 2-year animal experiment we successfully performed the operation in a patient with recurrent carcinoid of the trachea, radically resected the tumor and primarily reconstructed the trachea.</p><p><b>RESULTS</b>The inner side of this "sandwich" artificial tracheal prosthesis was coated with skin and outside the memory-alloy mesh was muscle and vessel pedicle with good blood supply. The upper and lower anastomosis completely healed with recipient's trachea with a full recovery of trachea. Six-month follow-up showed that the patients resumed their normal life.</p><p><b>CONCLUSION</b>The artificial trachea completely healed with the native trachea and became a part of the human trachea. The inner side of artificial trachea is coated with intact native skin tissue with ample blood supply, totally alive without rejection. Therefore, the pedicled artificial tracheal prosthesis is an real artificial trachea.</p>

A comparative study of computer assistant sperm analysis with rontine sperm analysis / 浙江大学学报·医学版

OBJECTIVE: To compare computer assisted sperm analysis (CASA) with routine sperm analysis (RSA) in evaluation of male fertility. METHODS: The results of CASA were compared with the RSA of 27 males normal fertility and 317 males with infertility. RESULTS: Using the CASA, deformity rate was lower than RSA, it was 25.10+/-8.57 and 31.48+/-12.81 in the fertile and infertile groups respectively, whereas, RSA was 35.56+/-9.58 and 54.56+/-13.47. Fertile group motility had a significant difference, it was 61.35+/-7.62 and 83.96+/-6.67. Sperm vitality of grades A was 9.10+/-5.50 and 30.33+/-8.85. The vitality of grades B was 31.16+/- 12.35 and 49.93+/-8.56, the vitality of grades C awas 21.06 +/-14.19,and 3.70+/-2.12, the vitality of grades D was 38.66+/-7.62 and 16.04+/-6.67. When two techniques were adopted, the mobility had no difference in infertile group (42.53+/-14.95 and 43.09+/-13.96), the sperm vitality was decreased in grades B (CASA 22.67+/-14.96,RSA 33.32+/-13.47), increased in grades C(CASA 17.08+/-13.47,RSA 7.68+/-5.82), they had significant differences (P<0.01). The grade B sperms in the non-forward moving group, CASA was 2.77+/-6.01, RSA 0. In addition, VSL, VCL, VAP, ALH, sperm trace and static diagram were adopted. CONCLUSION: Using the CASA,the distinguished ability to sperm shape and vigor was lower than RSA, but the quantize marker (such as straight line velocity, curved velocity, average path velocity and ALH) and moving, static images could reflect on sperms quality more objectively.