Processing and identification of delicate fat particles for clinical application / 中华医学美学美容杂志

Objective:In the process of fat grafting, there is no good solution to achieve delicate filling while retaining the viability of fat particle. There was still no research on the composition and activity of delicate fat particle. In this study, two different methods for delicate fat process were established to explore the feasibility and clinical efficacy.Methods:From December 2015 to June 2016, 5 patients (22-31 years old, with average 26.2 years) with abdominal liposuction in Shanghai Ninth People's Hospital were inclueded. The fat particles were obtained by floating method and filtration method respectively, and compared with emulsified fat/nanofat and traditional fat grafts. The cell viability and composition of adipose tissue were compared in each group through cell viability test, flow analysis and tissue staining.Results:The fat particles obtained by floating and filtration methods, emulsified fat could pass through OT needle. Cell viability test revealed the presence of living cells in the fat obtained by both methods, but not in the emulsified fat. Flow analysis showed that the expression of CD90 in floating group was higher than that in control group ( P=0.048). Conclusions:The delicate fat particle can be obtained by floating or filtration method, which can preserves the tissue integrity and cell viability; meanwhile it can achieve fine needle injection and clinical application.

Decellularized extracellular matrix mediates tissue construction and regeneration / 医学前沿

Contributing to organ formation and tissue regeneration, extracellular matrix (ECM) constituents provide tissue with three-dimensional (3D) structural integrity and cellular-function regulation. Containing the crucial traits of the cellular microenvironment, ECM substitutes mediate cell-matrix interactions to prompt stem-cell proliferation and differentiation for 3D organoid construction in vitro or tissue regeneration in vivo. However, these ECMs are often applied generically and have yet to be extensively developed for specific cell types in 3D cultures. Cultured cells also produce rich ECM, particularly stromal cells. Cellular ECM improves 3D culture development in vitro and tissue remodeling during wound healing after implantation into the host as well. Gaining better insight into ECM derived from either tissue or cells that regulate 3D tissue reconstruction or organ regeneration helps us to select, produce, and implant the most suitable ECM and thus promote 3D organoid culture and tissue remodeling for in vivo regeneration. Overall, the decellularization methodologies and tissue/cell-derived ECM as scaffolds or cellular-growth supplements used in cell propagation and differentiation for 3D tissue culture in vitro are discussed. Moreover, current preclinical applications by which ECM components modulate the wound-healing process are reviewed.

Analysis of 3 cases misdiagnosised with myasthenia gravis / 中华实用儿科临床杂志

The clinical data of 3 cases with myasthenia in Children′s Hospital of Fudan University were retrospectively analyzed.All the 3 patients were diagnosed with myasthenia gravis and given pyridostigmine bromide, but the treatment effect was unsatisfactory.One patient had left lower limb weakness and motor development impairment, and was diagnosed with centronuclear myopathy by gene testing.One patient had blepharoptosis, accompanied by developmental delay, facial deformity, and toe deformity.This patient was diagnosed with chromosome 18p syndrome by chromosome analysis.One patient had weakness of both legs, slight development retardation, and significantly high lactic acid levels.Basal nuclei lesions were observed under head magnetic resonance imaging (MRI). Whole exome sequencing (WES) and mitochondrial genome testing results revealed Leigh syndrome.Through summing up experience and lessons, strengthen and improve the clinical identification ability of clinicians for myasthenia gravis, and avoid misdiagnosis.

Experimental study of effect and mechanism of cysteine rich protein 61 on survival of adipose tissues in rats after autologous fat grafting / 器官移植

Objective To evaluate the effect and mechanism of cysteine rich protein 61, namely CCN family member 1(CCN1) on the survival of adipose tissues in rats after autologous fat grafting. Methods At 1 week after the establishment of autologous fat grafting rat models, all animals were randomly divided into the CCN1 group (n=20) and control group (n=20). The survival of fat grafts, the morphology of fat graft tissues, the proportion of active adipocytes and the number of new blood vessels of rats were statistically compared between two groups. The levels of differential expressed messenger ribonucleic acid (mRNA) in the fat graft tissues of rats were compared between two groups by high-throughput sequencing and subsequently subject to cluster analysis. The expression levels of related proinflammatory cytokines of fat graft tissues of rats were statistically compared between two groups. Results The weight retention rate of adipose tissues in the CCN1 group was significantly higher than that in the control group (P < 0.05). In the CCN1 group, the integrity of adipocytes was considerably higher, the degree of vesiculation and vacuolation, the degree of inflammatory cell aggregation and the degree of fibrosis were significantly lower than those in the control group (all P < 0.000 1). Immunofluorescence staining demonstrated that the proportion of active adipocytes with uniform morphology was higher in the CCN1 group, whereas the proportion of active adipocytes was lower and the cells were observed in different sizes accompanied by vesiculation in the control group. Compared with the control group, the quantity of new blood vessels was significantly higher, and the expression levels of platelet derived growth factor (PDGF) and fibroblast growth factor (FGF) mRNA were remarkably higher in the CCN1 group (all P < 0.05). High-throughput sequencing analysis showed that the data at the transcriptome levels significantly differed between two groups. In the CCN1 group, the gene expression levels of cell surface markers, inflammatory cytokines and chemokines related to M1 macrophages tended to decline. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) revealed that the mRNA expression levels of interleukin (IL)-8, IL-1 and Toll-like receptor (TLR) 2 in the CCN1 group were significantly lower than those in the control group (P < 0.01-0.05). Conclusions During autologous fat grafting, supplement of exogenous CCN1 may effectively promote the neovascularization of adipose tissues and improve the survival rate of fat graft probably by mediating the transformation of macrophages into M2 phenotype via down-regulating the TLR2 expression level.

Coupled convolutional and graph network-based diagnosis of Alzheimer's disease using MRI / 南方医科大学学报

OBJECTIVE@#To propose a coupled convolutional and graph convolutional network (CCGCN) model for diagnosis of Alzheimer's disease (AD) and its prodromal stage.@*METHODS@#The disease-related brain regions generated by group-wise comparison were used as the input. The convolutional neural networks (CNNs) were used to extract disease-related features from different locations on brain magnetic resonance (MR) images. The generated features via the graph convolutional network (GCN) were processed, and graph pooling was performed to analyze the inherent relationship between the brain topology and the diagnosis task adaptively. Through ADNI dataset, we acquired the accuracy, sensitivity and specificity of the diagnosis tasks for AD and its prodromal stages, followed by an ablation study on the model structure.@*RESULTS@#The CCGCN model outperformed the current state-of-the-art methods and showed a classification accuracy of 92.5% for AD with a sensitivity of 88.1% and a specificity of 96.0%.@*CONCLUSIONS@#Based on the structural and topological features of the brain MR images, the proposed CCGCN model shows excellent performance in AD diagnosis and is expected to provide important assistance to physicians in disease diagnosis.

Advances in the drug clinical trials of neurofibromatosis type Ⅰ-associated plexiform neurofibromas / 中华整形外科杂志

Neurofibromatosis type Ⅰ(NF1)is an autosomal dominant genetic disease triggered by mutations of nf1gene, nf1 gene and its encoded protein product neurofibromatoprotein play important roles in tumor supressive activity. Plexiform neurofibroma was the main manifestation among some patients For plexiform neurofibroma, surgical treatment did not have satisfactory effect. meanwhile, traditional radiotherapy and chemotherapy are ineffective. All of those above serve as challenges for clinical treatment and have been received much more attention from study of multimoics and targeting therapy In this Review, the clinical features of NF1-associated plexiform neurofibromasand, the progress regarding investigation of drug targets and clinical trials for the drug of plexiform neurofibroma will be presented.

Use of autologous fat grafting in prevention and treatment of expansion complications / 中华医学美学美容杂志

Objective:To explore the effectiveness of autologous fat grafting in the treatment of undesirable skin expansion.Methods:Patients' data were reviewed from 2011 to 2016, including the expanded regions with early signs of skin complications in face and neck. The effects of fat grafting group and control group were evaluated by follow-up records of expansion volume, skin thickness, skin texture and local capillary reaction.Results:Fat grafting could increase the thickness of expanded skin. It also improved the texture of expanded skin, with 0.83± 0.71 points before treatment and 1.30±0.66 points after treatment ( P=0.04). The local capillary reaction was also improved from 1.06±0.54 points before treatment and 1.45±0.51 points after treatment ( P=0.03). The expansion in the fat grafting group was 2.21±0.57 times before treatment and 2.94±0.83 times after treatment. In the control group, the expansion was 2.19 times when it showed early signs, and no obvious changes were observed during the follow-up period. Conclusions:Autologous fat grafting can effectively treat complications of skin expansion, prolong expansion process and promote tissue regeneration.

Therapeutic effect of antitoxin on botulism type A: a preliminary observation of 8 cases / 中华整形外科杂志

Objective@#The study aimed to explore the recommended treatment for toxicosis of botulism toxin type A.@*Methods@#From January 2016 to August 2017, 8 patients with toxicosis of botulism toxin type A were hospitalized in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine. All patients were female, 21-33 years of age, with an average age of 26.4 years. All patients showed progressive myasthenia and abnormal electromyography. The clinical manifestations and treatment outcomes of 8 patients in antitoxin group or non-antitoxin group were retrospectively analyzed. Five patients treated in plastic and reconstructive surgery department were included in the antitoxin group. They received skin test before injection, followed by intramuscular injection of 10 000-20 000 U antitoxins once a day for 2-3 days. Three patients treated in neurology department were included in the non-antitoxin group. They received only intravenous drip of neurotrophic drugs. After treatment, the improvement of clinical symptoms such as myasthenia and blepharoptosis was observed, and the electromyogram was followed up.@*Results@#The symptoms of myasthenia of the 5 patients in antitoxin treatment group were significantly improved, and the electromyogram signal returned to normal. However, for the 3 patients in non-antitoxin group, the symptoms of myasthenia did not significantly improve, and their electromyogram signal did not return to normal, even after 5 days′continuous treatment.@*Conclusions@#To regulate the cosmetic medical market is the key to prevent the accident of toxicosis of botulism toxin type A. It is necessary to make a definite diagnosis and medical intervene in time for the toxicosis. Antitoxin has a better curative effect, but further research is needed, to verify its safety and effectiveness.

Reconstruction of facial disfigurement with flap prefabrication technique: a 12-year experience / 中华整形外科杂志

Objective@#To summarize clinical experience on reconstruction of severe facial disfigurement with flap prefabrication and soft tissue expansion.@*Methods@#From September 2005 to June 2016, 49 patients with type Ⅲ and type Ⅳ facial deformities underwent facial reconstruction with an integrated method on the basis of prefabricated flaps. In the first stage, the descending branch of the lateral femoral circumflex vessels and the surrounding muscle fascia were dissected and transferred to subcutaneous pocket in the cervicothoracic area. The pedicles of the fascial flap were anastomosed to either the facial or superior thyroid artery and their venae comitantes in flap prefabrication. A tissue expander was placed beneath the fascial flap. In the second stage, over-expansion was achieved with intra-flap stem cell transplantation once patient′s skin showed signs of intolerance to expansion. In the third stage, prefabricated flap was transferred to cover the facial defects. the second or third internal mammary artery perforators or lateral thoracic artery perforators were reserved and flap supercharging would be performed depending on the perfusion of the flap revealed by indocyanine green angiography intra-operatively. Later, flap revisions further restored facial outline and delicate organ configuration. Aesthetic and functional status were independently graded to assess the facial appearance and function before and after the reconstruction.@*Results@#49 patients with severe facial deformities were included. 5 patients received stem cell transplantation. The final inflated volume ranged from 2 530 ml to 3500 ml and each patient had facial reconstruction with a prefabricated flap (range 23 cm×18 cm-34 cm×32 cm). Flap supercharging technique were used in 25 cases to augment blood perfusion, however, flap necrosis (5 cm× 2 cm) occurred in 1 patient, and tip necrosis occurred in 4 patients, otherwise, all flaps survived entirely. The aesthetic (1.15 to 2.29) and functional (0.86 to 2.42) status scores were statistically improved (P<0.01). Facial expressions such as smiling, blinking and frowning were noted.@*Conclusions@#Autologous full face reconstruction with an integrated method based on flap prefabrication can bring satisfying aesthetic and functional recovery, rendering a safe and effective option for most patients with massive facial defects.

Interpretation of the International Standard 2017 Version of Implantable Neurostimulators / 中国医疗器械杂志

ISO 14708-3 "Implants for surgery-active implantable medical devices-Part 3:implantable neurostimulators" 2017 version and 2008 version are compared, and changes in the standard are interpreted combined with the characteristics of the neurostimulator. The new version of the standard for the first time in the introduction mentioned a new type of non-electrode or extension's neurostimulator. Key issues that have significant impact on safety concerns such as wireless charging temperature rise, MRI acceptance criteria, etc., are given for the first time in the new version. New requirements to the wireless communication section are added, and the electromagnetic compatibility part is greatly adjusted. With more miniature non-electrode or extension's neurostimulator entering the market, standards such as electromagnetic compatibility and MRI, there will be greater adjustments.

Clinical efficacy of percutaneous nephrolithotomy with holmium laser and no help of irrigating pump in the treatment of renal calculi:report of 127 cases / 中国基层医药

Objective To observe the clinical efficacy of percutaneous nephrolithotomy ( PCNL ) with Holmium laser and no help of irrigating pump in the treatment of renal calculi in 127 cases.Methods From January 2012 to November 2017 ,a total of 127 patients with renal calculi have suffered mini -PCNL with Holmium laser and no help of irrigating pump by using 16F or 18F Urovision percutaneous nephrostomy kit in Peking University Shougang Hospital ,the Hospital of Mentougou District and the Traditional Chinese Medicine Hospital of Mentougou District were collected.The operation time, intraoperative blood loss, hospitalization stay, lithotripsy rate, stone clearance and principal complications of operation were analyzed statistically .Results The first phase success rate of percutaneous nephrostomy was 100％, lithotripsy rate was 24.4％, stone clearance rate was 24.4％.The operation time was (36.1 ±15.6)min.The intraoperative blood loss was (45.4 ±31.7)mL.But postoperative abdominal X-ray showed that 96 patients with residual calculi ≥ 4mm needed to receive the second look PCNL .These 96 patients reached 100.0％ of lithotripsy rate and 100.0％ of stone clearance postoperatively .The operation time was ( 64.5 ± 31.1)min.The intraoperative blood loss was (23.1 ±21.9)mL.No severe complications such as massive hemorrhage occurred.The hospitalization stay was (12 ±5 ) d.Conclusion Larger renal calculus except complete staghorn calculus,and upper ureteral calculus are the indications for PCNL with Holmium laser and no help of irrigating pump . It is safe and feasible to perform PCNL with Holmium laser and no help of irrigating pump .

Effect of microRNA-129 expression on proliferation,apoptosis and cell cycle of esophageal squamous cell cancer and its possible molecular mechanism / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect of microRNA-129(miR-129)expression on malignant phenotypes of esophageal squamous cell cancer(ESCC) cells and its possible molecular mechanisms. METHODS The constructed miR-129-overexpressed vector (pGCMV/EGFP/miR-129) and negative control vector (pGCMV/EGFP/miR-NC) were stably transfected into ESCC cell lines (Eca109 and EC9706),respectively. Quantitative real-time PCR(qRT-PCR)was performed to detect the expression of miR-129. MTT and flow cytometry(FCM)assays were performed to analyze the effects of miR-129 on proliferation, cell cycle and apoptosis of ESCC cells. Furthermore,a luciferase reporter vector with the putative B-cell lymphoma-2(Bcl-2)3′-untranslated region(pLUC/Bcl-2-3′-UTR-wt and pLUC/Bcl-2-3′-UTR-mut)was constructed to explore whether Bcl-2 was a direct target gene of miR-129 by detecting luciferase activity. Next,Western blotting was performed to detect the expression of Bcl-2, cleaved caspase 3 and total caspase 3 proteins. RESULTS Overexpression of miR-129 significantly inhibited proliferation(P<0.01),induced cell arrest in G0/G1 phase(P<0.05)and enhanced apoptosis (P<0.05)in ESCC cells. Luciferase reporter assay indicated that Bcl-2 was identified as a direct target gene of miR-129. Results of Western blotting showed that overexpression of miR-129 significantly reduced the expression of Bcl-2 protein and increased the expression of cleaved caspase 3 protein,but induced no changes in total caspase 3 protein in ESCC cells. CONCLUSION miR-129 functions as a tumor suppressor in ESCC cells by targeting Bcl-2 gene. Therefore,miR-129 will be a potential molecular target for the treatment of human ESCC.

Effect of local mild hypothermia on regional cerebral blood flow in patients with cerebral infarction assessed by 99mTc-ECD SPECT imaging / 实用医学杂志

Objective To investigate the frequency of lesions detection in patients with cerebral infarction (CI) with SPECT/CT. To investigate fluctuation of regional cerebral blood flow (rCBF) and its relationship with clinical symptoms. Methods Sixty-seven CI patients without cerebellar lesion were randomly selected. The rCBF in the regions of interest (ROI) was examined by SPECT/CT, which was collected from the frontal lobe, temporal lobe, parietal lobe, occipital lobe, thalamus, basal ganglia and cerebellum. The rCBF index was calculated. The association between fluctuation of rCBF index and clinical symptoms of patients was explored. Results There were 251 positive regions in all viewing regions , the total positive rate was 31.2%. The left side was 38.1%, while the right side was 24.4% (χ2=17.522,P 0.05). However, the average rCBF on the left parietal lobe was lower (P 0.05). rCBF≥0.7 is a clinical sign of abnormal ROI. Conclusion 30% of ROI of CI patients have lesions and the positive rate of the left side was higher. The biological rCBF values of all lobes were different. Therefore, rCBF index could be used to reflect whether the ROI is normal. rCBF≥0.7 could be used as a sign to quantitatively assess abnormal ROI in clinical practice.

The prognostic analysis of dose adjustment for beta blockers in the acute exacerbation of chronic congestive heart failure in the elderly / 中国基层医药

Objective To evaluate the effects and the prognosis of beta receptor blocker (metoprolol)dose adjustment of senile patients with chronic congestive heart failure (CHF)of acute exacerbation,and to provide reference for clinical treatment.Methods 76 cases with chronic CHF in acute exacerbation who treated with beta blockers and other reasonable treatment were randomly divided into half dose group (40 cases)and full stop group (36 cases).After adjusted for 3 months,the clinical symptoms were observed,noninvasive hemodynamic machine was used to detect cardiac index (CI),left cardiac work (LCW),cardiac output (CO)and changes of other indicators. Immunoradiometric analysis was used to detect plasma type B natriuretic peptide (BNP).Results 72h after treatment,in the half dose group,the progression of the disease in 13 cases,improved in 27 cases,in the full stop group,progression in 20 cases,improvement in 16 cases,the difference was statistically significant (χ2 =4.09,P <0.05).Before the adjustment of metoprolol,the index of the two groups had statistically significant difference(χ2 =4.52,P <0.05 ).Compared with pretreatment,the changes of NYHA classification,Co,CI,LCW of the half dose group were not obvious,and he change of NYHA of the full stop group was obvious,,III /IV the progression of the disease the number of cases increased in 5 cases and 3 cases,Co,Ci,LCW were reduced by about 25%,35% and 30%.After the adjustment of metoprolol,BNP of the half dose group was (321.8 ±97.6 )mg/L,which was significantly lower than (422.3 ±139.4)mg/L of the full stop group,the difference was statistically significant (t =3.94,P <0.05 ).Conclusion In the patients with beta blockers combined with other reasonable treatment, CHF patients with acute exacerbation of the beta blockers than the discontinuation of the prognosis,and the safety is high.

Application of microbublle-enhanced ultrasound in preoperative mapping of perforators in supraclavicular artery based flaps / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.</p><p><b>METHODS</b>From May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.</p><p><b>RESULTS</b>There were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.</p><p><b>CONCLUSIONS</b>The perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.</p>

A comparitive study between conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gastrointestinal endoscopy / 中华消化内镜杂志

Objective To study the induction of nitrous oxide(N2 O)and to compare safety and effec-tiveness of conscious sedation by nitrous oxide inhalation and intravenous sedation with propofol for upper gas-trointestinal(UGI)endoscopy.Methods A total of 400 patients undergoing UGI endoscopy in our hospital from April 2013 to October 2013 were randomly assigned to two groups,N2 O inhalation group(n=200)and in-travenous propofol group(n=200).The systolic pressures,diastolic pressures,heart rates and oxygen satura-tion,onset time,procedure duration,degree of sedation,recovery time,length of hospital stay,complica-tions,satisfaction ratings of doctors and patients,and the number of patients willing to accept the examination again were analyzed.Results The mean time of ideal anesthesia state for N2 O was (3. 16 ±0. 65 )min and there was no difference between the male and female(3. 16 ±0. 71)min vs.(3. 16 ±0. 58)min,t=0. 006,P>0. 05).The mean concentration was (43. 68 ±5. 05 )%,which was higher in male than that in female [(45. 3 ±4. 99)% vs.(41. 46 ±4. 30)%,t=3. 042,P sures,diastolic pressures,heart rates and oxygen saturation of patients in the propofol group significantly re-duced during the procedure(P<0. 05),while the same measurements excluding oxygen saturation for those in the N2 O group significantly increased(P<0. 05 ).Compared with the propofol group,patients inhaling N2 O had significantly shorter recovery and hospital stay time,but a longer onset time and procedure duration(P<0. 05 ).Complications that occurred in some patients of propofol group included hyoxemia,hypotension,brady-cardia,while the major complication in the N2 O group was nausea.The satisfaction ratings of doctors or pa-tients and the number of patients willing to accept the examination again in N2 O group were smaller than those in propofol group(86 ±3. 7 vs.96 ±2. 6,87 ±2. 8 vs.98 ±1. 2,87%vs.99%,P<0. 05).Conclusion Both conscious sedation by N2 O inhalation and intravenous sedation with propofol are effective for diagnostic UGI en-doscopy,but the safety of the former is superior to the latter.The key to complete the conscious sedation by ni-trous oxide inhalation is to accurately identify the ideal anesthesia state of N2 O.It is significant to pay attention to the nine factors concerning safe and effective sedation during operation.

Comparison of effectiveness between micro-plasma technology and 2940 nm Er ∶ YAG laser in treatment of burn scar / 中华医学美学美容杂志

Objective To compare the effectiveness,indications and side effect between microplasma technology (MPT) and 2940 nm Er ∶ YAG laser for treatment of burn scar.Methods 265 patients with hypertrophic scar were treated with MPT (MPT group,N=136) and Er ∶ YAG laser (Er ∶ YAG laser group,N=129).The patients were treated 2-6 times.Results The significant response rate was 73.52 ％ and 44.95 ％ in MPT group and Er ∶ YAG laser group; the cure rate was 28.67 ％ and 15.50 ％ in MPT group and Er ∶ YAG group,respectively.There was no statistically significant difference between two groups (P＞0.05).For moderate burn scar patients (93 cases),the significant response rate was 62.79 ％ and 10.00 ％ in MPT group and Er ∶ YAG laser group,respectively.There was significant difference between two groups (P＜0.05).Conclusions MPT and Er ∶ YAG laser has been proven to be effective and safe for the treatment of burn scar.The effectiveness of MPT is superior to Er ∶ YAG laser in treatment of moderate burn scar.

Indications, Outcomes, and Complications of Pedicled Propeller Perforator Flaps for Upper Body Defects: A Systematic Review

BACKGROUND: The aim of this investigation was to systematically review the current literature to provide the best data for indications, outcomes, survival, and complication rates of pedicled propeller perforator flaps for upper body defects. METHODS: A comprehensive literature review for articles published from January 1991 to December 2011 was performed using the PubMed, Medline, and Cochrane Databases. Articles without available full-text, single case reports or papers with excessive missing data were excluded. Papers reporting pedicle-perforator (propeller) flaps used for lower extremity reconstruction were excluded from meta-analysis. RESULTS: From the initial 1,736 studies our search yielded, 343 studies qualified for the second stage of selection. Of 117 full-text reports screened, 41 studies, met the definitive inclusion and exclusion criteria. Of the selected 41 articles, 26 were case series, original papers or retrospective reviews and were included, whereas 15 were case report papers and therefore were excluded. Two hundred ninety-five propeller flaps were reported to have been used in a total of 283 patients. Indications include repair of trauma-induced injuries, post-trauma revision surgery, cancer resection, chronic infection, pressure sores, and chronic ulcers with a major complication rate (3.3%) comparable to that of free flaps. No specific exclusion criteria for the procedure were presented in the studies reviewed. CONCLUSIONS: Pedicled propeller flaps are a versatile and safe reconstructive option that are easy and quick to raise and that provide unlimited clinical solutions because of the theoretical possibility of harvesting them based on any perforator chosen among those classified in the body.

Rituximab in combination with conformal radiotherapy treatment of postoperative primary central nervous system lymphoma / 白血病·淋巴瘤

Objective To analyze the long-term results of rituximab combined with whole brain radiotherapy and 3-dimentional conformal radiotherapy (3D-CRT) in treatment of patients with primary central nervous system lymphoma (PCNSL). Methods 23 postoperative patients younger than 60 years old were treated. Whole brain radiotherapy with dose of 32.4 Gy were performed and lesions were followed by 3D-CRT with dose of 18 Gy.A dose of rituximab (375 mg/m2) was infused on day 1 (once a week for six weeks).The overall survival was analyzed by using Kaplan-Meier.Results 19 patients(82.6 ％) was complete remission 3 patients (13.0 ％) was part remission,14 patients (60.9 ％) was progression-free survival was 26 months (17-34 months). The overall survival was 40 months (29-55 months). Toxicity was moderate without grade 3-4 neurotoxicity toxic events. Conclusions Radiotherapy (whole brain radiotherapy with sequential 3D-CRT)combined with rituximab seems to yield substantial long-term survival with moderate toxicity for the treatment of the younger patients with PCNSL.

Transnasal endoscopic marsupialization for treatment of maxillary cysts / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effectiveness and usefulness of transnasal endoscopic surgery for the treatment of maxillary cysts.@*METHOD@#Transnasal endoscopic surgery was performed in 13 patients with maxillary cysts that extended to the maxillary sinus or the nasal bottom. Five patients had a radicular cyst, three patients had a dentigerous cyst, three patients had a nasolabial cyst and two patients had a median cyst. After the resection of anterior edge of the inferior turbinate or the nasal bottom, the lateral wall of the inferior nasal meatus was opened. Then, the cyst wall of the maxillary sinus was partially or completely removed under the endoscope.@*RESULT@#The cyst walls were completely or partial removed in 13 patients with maxillary cysts. There were no complications, and postoperative courses were uneventful. The follow-up period ranged from 6 to 36 months, and no recurrence were noted in any of the cases.@*CONCLUSION@#Endoscopic transnasal surgery for the maxillary cyst is less invasive than conventional dental approach, and most of the affected teeth can be preserved. This technique appears to be a simple and highly effective surgical treatment for the treatment of patients with maxillary cysts that extend to the maxillary sinus or the nasal bottom.