Rational use of antibacterials and drug sensitivity analysis in the repair of large lip defect with skin flap

In this study the wound status of skin flap repair patients were closely observed, there were sign of infection. The secretion were taken for bacterial culture and sensitivity analysis and given sensitive antibiotics to active treatment.

Patients received intravenous antibiotics 30 minutes before surgery to prevent infection. If postoperative infection occurred, according to susceptibility test results, patients were given sensitive antibiotics. Drug sensitivity analysis

showed that 85.71% of gram-negative bacteria were sensitive to cefoperazone/shubatan and imipenem and 72.72% of gram-negative bacteria were sensitive to cefoperazone/tazobactam, so these 3 antibiotics were the first choice for

treatment. And gram-positive bacteria were sensitive to teicoplanin and vancomycin. Therefore, scientific and rational use of antibiotics has great significance to effectively prevent postoperative infection and reduce the production of drugresistant bacteria. At the same time, L-extension deltopectoral flap was used to reconstruct a full-thickness labiomental defect concurrent infection. All the surgeries were successful without any necrosis. There are many kinds of pathogens for skin flap infection, and their sensitivity to antibiotics is not the same. Therefore, it is suggested that combination therapy should be carried out at the early stage, so as to ensure a good antibacterial effect

Bilobed platysma myocutaneous flap in reconstruction of mandibular region cutaneous defect

Reconstruction of large cutaneous defects is a challenging task for plastic surgeons. When the skin defect is only part of the complex defects after expansion resection of oral cancer and neck dissection should be done at the same time, it is a daunting task to obtain a cosmetic post-operative appearance. We designed bilobed platysma myocutaneous flaps to reconstruct the mandibular region cutaneous defects. And at the same time, the incessant of the bilobed flap can be a combined incision of platysma myocutaneous flap and neck dissection and can be used to expose fully the region of neck dissection and to supply a large enough platysma flap to reconstruct the mandibular skin defect. This design has several advantages and worth to be promoted

impact of parental presence in preschool children facial trauma surgery

Wound repair surgeries are the most common childhood surgery in most countries. Medical treatment itself will impact children's mental health. The authors' objective was to study the impact of parental presence in preschool children and to reveal the conditions and precautions of it. Parental presence during facial trauma surgeries was analyzed, a group of 49 preschool children from April 1, 2013 to April 30, 2013 and their parents attended the experiment, contrasting with a group of 57 preschool children without parental presence. By means of clinical observation and questionnaire, the wound infection rate, surgery satisfaction, children and parents' anxiety level were studied. The authors found that parental presence would not increase the Infection rate. Parental presence could reduce children's and their parents' anxiety level and increase the surgery satisfaction rate. Parental presence has a lot of positive significances about the children's emergency surgery, children's health care and parents' anxiety

Effect of alcohol extract of Cortex Eucommiae on oxidative stress markers in serum of brain aging model mice / 国际药学研究杂志

Objective To explore the effect of Cortex Eucommiae(CE)extract on oxidative stress markers of brain aging mice. Methods Brain aging mice model was made via subcutaneously administered D-galactose. The ethanol extract of CE was intra?gastrically administered to the model mice. Apoptosis ratio of brain cells of mice was determined by a flow cytometry to evaluate the an?ti-aging function of CE extract. A series of biomarkers related to oxidation,including malonyldialdehyde(MDA),superoxide dis?mutase(SOD),protein carbonyl(PCO),and nitric oxide(NO)in serum of mice were determined by ELISA. Results Compared with the model mice,the apoptosis ratio of brain cells in the CE extract group decreased significantly(P<0.01). ELISA test results showed that,compared with the normal group,NO and SOD levels in serum of CE extract group were significantly higher(P<0.01). Compared with the model group,MDA and PCO levels in serum of CE extract group were significantly lower(P<0.01),and SOD level was obviously higher(P<0.01). Conclusion The CE extract might play the role of brain anti-aging by the effective attenuation of ox?idative damage.

Sampling comparative analysis on military flying cadets by comprehensive assessment for two years / 军事医学

Objective To analyze the change in qualification rate of comprehensive assessment , and to provide an effective theoretical basis for future selection and recruitment of military flying cadets .Methods Group A consisted of 400 cadets who were randomly chosen from the final selection with the physical examination conclusions of disqualifiedandqualified by comprehensive assessmentin a certain year via the cross-sectional investigation method , and group B was composed of 400 cadets who were chosen from the following year with the same method as group A .A questionnaire con-cerning demographic features was conducted among all cadets .A database was established with Epidata 3.02 software, and SPSS 16.0 software was used to analyze diseases which were qualified by comprehensive assessment.Results The qualification rate of comprehensive assessment in group A was higher than group B (45.00%vs 34.75%, P<0.01),there were differences between the two groups in overweight ( underweight ) ,deflection of nasal septum , gallbladder polyp , spinal malformation and undertall(P<0.05 or P<0.01).Conclusion The expert consensus which is made by the air force ex-perts through their work experience and the foreign air force standards has a positive application effect in the practical work . It is an efficient supplement to the physical examination standards and has an important effect on military aviator selection .

Treatment and outcome of recurrent cervical lymph nodes in patients with nasopharyngeal carcinoma after radiotherapy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacies of different treatments for recurrent cervical lymph nodes and the factors contributing to prognosis in patients with nasopharyngeal carcinoma after radiotherapy.</p><p><b>METHODS</b>Clinical data of 79 patients with nasopharyngeal carcinoma after radiotherapy were retrospectively analyzed, and all cases were diagnosed as having recurrent cervical lymph nodes by pathological examination. The factors including sex, age, the interval between completion of radiotherapy and recurrence, rN stage, treatment methods, and the location relationship between recurrent lesion and primary tumor in the neck were analyzed for prognosis. Kaplan-Meier curves, Log-rank test and Cox's proportional hazards regression mode were used in the statistical analysis.</p><p><b>RESULTS</b>The median recurrence time was 26 months, and the 1- , 3- and 5-year overall survival rates were 77.9%, 53.4% and 39.7%. Cox's proportional hazards regression mode analysis indicated that age, rN stage, treatment methods, and the location relationship between recurrent lesion and primary tumor were significantly prognostic factors.</p><p><b>CONCLUSIONS</b>Neck dissection is superior to re-radiotherapy in treatment of recurrent cervical lymph nodes in nasopharyngeal carcinoma after radiotherapy. The patients younger than 45 years old, in early rN stage and for recurrence in the center region of primary tumor have a better prognosis.</p>

Analyses of therapeutic and prognostic factors for rN3 neck recurrence of nasopharyngeal carcinoma after primary radiotherapy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the treatment and prognosis for rN3 neck recurrence of nasopharyngeal carcinoma (NPC) after primary radiotherapy.</p><p><b>METHODS</b>A total of 37 cases with rN3 neck recurrence after radiotherapy in NPC between October 2003 and August 2013 were retrospectively analyzed. Of them 19 cases presented with lymph node (LN) metastasis in supraclavicular fossa, 18 cases had metastasis LN > 6 cm, 10 cases received chemoradiotherapy, and 27 cases underwent neck dissection including modified radical neck dissection (MRND) for 9 cases, radical neck dissection (RND) for 18 cases. Six of 18 cases with RND underwent reconstructive surgery with pectoralis major flap, 12 cases received postoperative radiotherapy and 20 cases had postoperative adjuvant chemotherapy.</p><p><b>RESULTS</b>Eight patients had documented recurrence or residue, 17 patients developed distant metastases, one patient showed recurrence and distant metastasis. The 5-year overall survival rate and disease-free survival rate were 27.5% and 21.6% respectively, and the median survival time was 41 months. The survival rate in surgery group was significantly higher than that in chemoradiotherapy group, and the prognosis of patients with LN > 6 cm was better than that of patients with metastasis LN to supraclavicular fossa.</p><p><b>CONCLUSIONS</b>Patients with rN3 NPC are prone to metastasis, and patients with supraclavicular fossa lymph node metastasis had poor prognosis. Surgery combined with chemoradiotherapy is an effective treatment for the patients without distant metastasis.</p>

Analysis of qualified military flying cadets by comprehensive assessment / 军事医学

Objective To provide an effective theoretical basis for future selection and recruitment of military flying cadets.Methods Two hundred military qualified flying cadets by comprehensive assessment samples and 200 military flying cadets by medical fitness samples were interviewed with questionnaires and subjected to a physical examination.The comprehensive assessment samples were classified by symptoms and attributive specialties for statistical analysis.A database was established, cleaned and analyzed by EpiData 3.02, SPSS 16.0 with double checking.Results There was no differ-ence between the comprehensive assessment team and the medical fitness team in age, areas, academic scores and psycho-logical performance.The ten top symptoms according to the comprehensive assessment were abnormal chest circumference, abnormal body mass,iris cyst,abnormal hypersplenotrophy,gallbladder polyps,flat foot,skin disease, intrahepatic calcifica-tion focus, joint disease and reproductive system disease.The attributed specialties included surgery, ultrasonics, ophthal-mology,ENT,radiology, ECG and internal medicine departments.The surgery and ultrasonics department contributed the most from the comprehensive assessment and accounted for 55.52%and 16.37%, respectively.Conclusion The compre-hensive assessment for military flying cadets has an important effect on military aviator selection.Continuous observation should be carried out among the military flying cadets by comprehensive assessment in their aviation training.

Value of Vienna Test System in psychological screening of flying cadets / 军事医学

Objective To study the applicability of Vienna Test System ( VTS) to psychological screening of flying cadets,and to establish a corresponding standard model for flying cadets .Methods VTS and pilot psychological selection system were used to evaluate the mental health of 134 cases of flying cadets , SPSS 13.0 was used to compare their consistency and relevance.Results The results of VTS included the raw score of overall mean duration [(46.68 ±21.06)s] on 2hand test, the correct reaction times (246.54 ±25.88) on DT test, the normal values of overall mean duration [(27.84 ±21.98)s] on 2 hand test,and the correct reaction times (60.57 ±18.61) on DT test and other indexes. Pearson coefficient was calculated as predictive validation .The composite score of VTS was significantly positively correla-ted with the first platform(r=0.46,P<0.0001), the second platform(r=0.27,P<0.05) and the psychological perform-ance of the pilot psychological selection system (r=0.31,P<0.05).Kappa-test showed that the two methods were highly consistent(Kappa=0.53).Conclusion The application of VTS to screening the mental health of flying cadets can yield and quick but accurate results , which are of high reliability and validity .It is undoubtedly of great significance for improving the level of aviation security ,objectivity of selection results and predictive validity .

Dynamic observation of EB virus DNA load before and after the treatment in patients with nasopharyngeal carcinoma and its clinical significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Dynamic observation of Epstein-Barr virus (EBV) DNA load before and after the treatment in patients with Nasopharyngeal carcinoma (NPC), predicting the incidence of distant metastasis and offering more personalised choice of therapies.@*METHOD@#Fifty-four cases of patients with NPC were taken by fluorescence quantitative PCR assay of EBV DNA load before and after the treatment, all patients were followed up according to plan and carried out the progression-free survival (PFS) and overall survival (OS).@*RESULT@#EBV DNA load in plasma of patients with NPC can partly reflect the clinical characteristics of patients; EBV DNA load in some patients with distant metastasis was higher than those patients with continuous remission when they were not started treatment (P < 0.05); For those patients whose EBV DNA copies were lower than 20,000 copies/mI before the treatment, the progression-free survival and overall survival rates were higher than those high expression patients, and the difference were statistically significant (PF < 0.01 and P < 0.05).@*CONCLUSION@#The EBV DNA load in the plasma of NPC patients can partly predict the occurrence of distant metastases before treatment.

Effect of p53 gene therapy on the local immunity and the efficacy of patients with nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the tumor regression and local immune function in nasopharyngeal carcinoma patients treated with p53 gene therapy.@*METHOD@#The two-step immunohistochemical was done to detect the expression of tumor-infiltrating lymphocytes (TIL) T-cell receptor-CD3, CD4, CD8 and B cell receptor-CD20 in the primary tumor tissue of nasopharyngeal carcinoma. Nasal endoscopy with MRI or CT was used for evaluation of tumor size.@*RESULT@#The expression of CD3, CD4, CD8 was significantly increased after p53 gene treatment (P 0.05). In conventional treatment group, CD3, CD4, CD8 and CD20 (P > 0.05) did not show any significant difference. In gene therapy group at 3 months after treatment, 20 patients had achieved CR, 10 PR, 1 SD, 1 PD. In conventional treatment group, 11 patients had achieved CR, 12 PR,5 SD,3 PD. The response rate between treatment group and control group (CR+PR) was different (P < 0.05). CD3 and CD4 expression was correlated with tumor regression rate (P < 0.05, P < 0.01), and CD8 expression was correlated with the CR rate (P < 0.05).@*CONCLUSION@#T cells are the most proliferative cell of TII. in NPC patients after p53 gene therapy The local cellular immune status is positively correlated with tumor regression rate.

Analysis of misdiagnosis of the skull base lesions with PET-CT / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the causes of misdiagnosis for skull base lesions by PET-CT, and to recognize the working principal and the false-positive results of PET-CT for reducing the misdiagnosis rate.@*METHOD@#The lesions of case 1 involved the pharynx nasalis, pterygopalatine fossa, and orbital apex base of skull, and the lesions of case 2 involved the base of sella were performed with CT, MRI and PET-CT examination. Both of the cases were treated with surgery and histopathologic examination.@*RESULT@#Two cases were diagnosed as nasopharyngeal carcinoma and carcinoma of base of sella by PET-CT, respectively. However, they were finally diagnosed mycosis and pituitary tumor by histopathologic examination after operation.@*CONCLUSION@#PET-CT examination in the skull base lesions may give false-positive result. Both clinical information and other imaging examinations should be considered to reduce the misdiagnosis skull base lesions only by PET-CT.