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Objective@#To observe the clinical application effect of blood circulation enhancement technique in repairing large area of skin and soft tissue defects of extremities with super large free anterolateral thigh flap.@*Methods@#From March 2014 to March 2017, 6 patients with large area of skin and soft tissue defects of extremities were hospitalized in our unit, including 5 males and 1 female, aged 27-65 years, 1 case of electric injury, 2 cases of coal burn, 3 cases of traffic injury, 2 cases involving upper limb, and 4 cases involving lower limb. After debridement, the wound area ranged from 26 cm×8 cm to 36 cm×15 cm, and the bone exposure area ranged from 24 cm×7 cm to 35 cm×14 cm. The blood circulation enhancement technique was used when the wound with bone exposure was repaired with super large free anterolateral thigh flap. The area of flaps ranged from 28 cm×10 cm to 38 cm×16 cm. The donor site of flap and the primary wound without bone exposure were repaired with medial thigh split-thickness skin graft of the donor leg of flap. The blood circulation enhancement technique mode during operation and the survival of flaps after operation were recorded, and the recovery of donor and recipient areas and the occurrence of complications were followed up.@*Results@#Three patients were treated with simple vascular supercharging technique during flap transplantation, and the other 3 patients were treated with vascular supercharging and turbocharging technique during flap transplantation. All the flaps survived well in 6 patients without vascular crisis. Follow-up for 3 to 12 months after surgery showed that the blood flow of the flaps was good and the depth and superficial sensation recovered to varying degrees. Except for 1 case of upper limb flap, the other flaps had no obvious swelling and needed no second thinning. There were only depressed scars in the donor sites, and no obvious scar hyperplasia in the area without bone exposure repaired by the skin grafts. No short-term or long-term complications were found.@*Conclusions@#The application of blood circulation enhancement technique in repairing large area of skin and soft tissue defects of extremities with super large free anterolateral thigh flaps provides reliable blood supply for the flaps and results in good effect after operation, which is worth popularizing.
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Objective@#To explore the impact of welding operations on the health status of workers with low working age, and provide a basis for occupational health risk assessment for workers of low working age.@*Methods@#Used the method of cluster sampling to randomly selected workers from an automobile manufacturing plant in Guangzhou as research subjects: 982 workers with welding posts of 1 year ≤working age ≤5 years were welding groups, 707 workers with simple exposure noise of 1 year ≤working age ≤5 years were assembly groups, and 717 workers in pre-job medical examinations were pre-job groups from June 2017 to September 2018. Then conducted occupational health checks on all subjects, investigated and detected the occupational hazards in welding posts and assembly posts.@*Results@#There was no statistical difference between the noise over-standard rate of welding posts' (59.3%, 16/27) and the assembly posts' (47.4%, 9/19) (P>0.05) . The over-standard rate of welding fume, manganese and its inorganic compounds in welding posts was 11.11% (3/27) . The results of occupational health examination showed that the detection rate of disease or abnormal of the welding group was 78.4% (770/982) higher than 70.2% (496/707) in the assembly group and 53.0% (380/717) in the pre-job group (the value of 2 were 14.92 and 122.37, respectively, P<0.05) . The rate of hearing loss of the assembly group and the welding group were 14.7% (104/707) and 19.3% (190/982) , respectively, which was higher than that of the pre-job group (10.5%, 75/717) , and the hearing loss rate gradually increased with the increase of working age (the value of linear-by-linear association were 12.04 and 44.67, respectively, P<0.01) . Compared with the hearing loss rate of each working age of the assembly group, the hearing loss rate of each working age of the welding group was higher, and when the working age was 3 years, the risk of hearing loss in the welding group was 2.70 times that of the assembly group (P<0.01) . The rate of pulmonary dysfunction in the welding group was 19.2% (189/982) higher than that in the pre-job group (12.6%, 90/717) , and it increased with the increase of working age (the value of linear-by-linear association was 15.97, P<0.01) .@*Conclusion@#Welding work seriously damages the health of workers with low working age, increases the hearing loss of workers and the occurrence of pulmonary dysfunction; manganese and its compounds increases noise-induced damage to the hearing system.
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Objective@#To investigate the clinical effects of perforating branch flaps of medial vastus muscle in repairing secondary wounds in donor sites of free anterolateral femoral perforator flaps.@*Methods@#From August 2014 to December 2016, 12 patients (8 males and 4 females, aged 35-72 years) with skin and soft tissue defects of extremities associated with tendon and bone exposure were treated in Hanzhong Central Hospital. The sizes of the primary wounds after debridement were 10 cm×8 cm-22 cm×14 cm, and the wounds were repaired with 12 cm×10 cm-24 cm×16 cm free anterolateral femoral perforator flaps. The anterolateral femoral donor sites, which were 8.0 cm×4.0 cm-14.0 cm×7.5 cm in the secondary wounds after skin extensional suture, were repaired with perforating branch flaps of medial vastus muscle in the size of 9.0 cm×5.0 cm-15.0 cm×8.5 cm. The medial femoral donor sites were sutured directly.@*Results@#All the perforating branch flaps of medial vastus muscle and free anterolateral femoral perforator flaps survived in 12 patients. Following up for 6 to 12 months, the medial femoral perforator flaps had good local shape and texture. The flaps of 8 patients without cutaneous nerve transection were sensitive. The sensation of the flaps of the other 4 patients gradually recovered, and the functions of the ipsilateral knee joints were normal.@*Conclusions@#The medial femoral perforator flap has a stable anatomy and abundant blood supply, which can be used to repair the secondary wound in the donor site of the free anterolateral femoral perforator flap conveniently. It is safe and easy to be popularized. Moreover, it has a good shape and function after operation.
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Objective@#To explore the relationship between occupational stress, psychological capital and depressive symptoms among electronic manufacturing female workers in the Pearl River Delta region.@*Methods@#Using cluster sampling method, 845 female workers from 5 electronic manufacturing enterprises in the Pearl River Delta region were selected as research subjects from June to August 2017. The Effort Reward Imbalance questionnaire (ERI) , Psychological Capital questionnaire-24 (PCQ-24) and Patient Health questionnaire-9 (PHQ-9) were applied to measure the level of occupational stress, psychological capital and depressive symptoms in female workers.@*Results@#Effort (r=0.197, P<0.01) and over commitment (r=-0.260, P<0.01) were positively correlated with the score of depressive symptoms, and the rewards was negatively correlated with depressive symptoms (r=-0.211, P<0.01) . The reward and over-commitment for depressive symptoms were accounted for 8.2%. Psychological capital was negatively correlated with depressive symptoms, and plays a partly mediating role in the relationship between occupational stress and depressive symptoms of female workers. The psychological capital for depressive symptoms was accounted for 8.7%.@*Conclusion@#Occupational stress can affects the depressive symptoms of electronic manufacturing female workers, or indirectly affect depressive symptoms through psychological capital, reduce occupational stress and improve psychological capital as a way to relieve the depressive symptoms of female workers.
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Objective@#To observe the effects of axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata on repairing defects after radical resection of scalp carcinoma in patients.@*Methods@#From February 2006 to December 2015, twenty-one patients with scalp carcinoma were admitted to our hospital, and the carcinoma invaded external lamina or full-thickness of skull and dura mater. After perfect preoperative examination, carcinoma and scalp tissue in 3 to 5 cm from the edge of carcinoma, external lamina or full-thickness of skull and invaded dura mater were resected and sentinel lymph nodes around carcinoma were cleaned in 3 to 4 days after admission. The postoperative defects with size reached from 11 cm×8 cm to 22 cm×18 cm. The flap transplantation was performed at the same time when quick frozen pathological examination results of resected scalp carcinoma margin tissue, skull, dura mater margin and basal tissue, and sentinel lymph nodes showed completely negative. Defects in 3 elderly patients were repaired by single or multiple axial scalp vascular network flaps, with the resected flaps size ranged from 12 cm×7 cm to 19 cm×14 cm. Defects in the other 18 patients were repaired by anterolateral thigh perforator flaps with fascia lata, with the resected flaps size ranged from 13 cm×10 cm to 23 cm×19 cm and the resected fascia lata size ranged from 8 cm×7 cm to 10 cm×10 cm. The head donor site of flap was repaired by medium thickness skin of head and back; the thigh donor site of flap was repaired by medium thickness skin of thigh on the same side. All patients gave up postoperative radiotherapy, chemotherapy, and other follow-up treatments.@*Results@#After operation, the flap and skin in all patients survived completely, with no vascular crisis or other condition. During the follow-up for 6 months to 9 years, all patients showed good appearance except for baldness in operation area of head, with no obvious malformation in head donor site of flap and skin, no swollen external hernia in the brain tissue, and no local recurrence or distant metastasis of carcinoma. The appearance of thigh donor site of flap and skin was good, with normal muscle strength and movement of lower limbs.@*Conclusions@#Patients with scalp carcinoma were performed with radical resection of carcinoma, and axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata were applied to repair the postoperative defects, with good appearance of head operation area and no local recurrence or distant metastasis of carcinoma.
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Objective To explore vascular endothelial growth factor-C (VEGF-C),vascular endothelial growth factor receptor 3 (VEGFR-3) in the bladder cancer tissue of the expression and the relationship with the tumor lymph node metastases of bladder cancer tissue,Methods The VEGF-C,VEGFR-3 expression was detected by Elivision TM plus two footwork.Results In 18 cases of bladder cancer organization,VEGF-C expression positive rate was 72％,VEGFR-3 express positive rate was 67％.VEGF-C in the bladder cancer of the transfer of the expression level compared to the lymph nodes of the transfer of the lymph node has not occurred to high.Conclusion In the bladder cancer organization and the surroundinglymph nodes,VEGF-C,VEGFR-3 expression level and lymph node metastasis is closely related.VEGF-C,VEGFR-3 expression intensity can be used as a lymph node metastasis in bladder cancer index.
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ObjectiveTo investigate the expression and biological significance of PIM1 in the breast cancer,atypical hyperplasia breast,and normal breast tissues.MethodsThe protein expression levels of PIM1 in the breast cancer,atypical hyperplasia breast,and normal breast tissues were assayed by immunohistochemistry and Western blot.ResultsThe expression rates of PIM1 protein were 78.75％ (63/80)in breast cancers,42.00％ (21/50) in atypical hyperplasia tissues,and 23.33 ％ (7/30) in normal breast tissues,respectively.A significant correlation was found between PIM1 expression and the clinical stage and lymphonodus metastasis.However,no significant correlation was found between PIM1 expression and patients'age and tumor sizes.The level of PIM1 protein in breast cancers was obviously higher than that in non - cancerous tissues.ConclusionsThe positive rate of PIM1 in breast cancers is significantly higher than that in atypical hyperplasia breast tissues and in normal breast tissues.PIM1 may be an early molecularevent in mammary tumorigenesis,and its overexpression may significantly relate to the malignant progression.It would be a new parameter for the early diagnosis and a biomarker for breast cancers.It is feasible to utilize paraffin specimens for index test with advantages of convenience,easy availability,and low expense.
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A total of 156 elderly patients (aged ≥ 70 years) with symptomatic bladder outlet obstruction as a result of benign prostatic hyperplasia (BPH) underwent trmsurethral photoselective vaporization (PVP). Pre- or post-operative urine flow rate, residual urine volume level, International Prostate Symptom Score (IPSS), and quality of life (QOL) score were recorded. Our data showed that maximum urine flow rate and residual urine volume were improved at 1, 12, 24, and 36 months following the treatment. There was statistically significant difference in IPSS and QOL when the intervention was considered (P < 0. 05). PVP might be a treatment of choice for high-risk elderly patients with obstructive BPH.