Application of soleus perforator flapfrom the lateral leg in repair of oral and maxil-lofacial defects / 医学研究生学报

ObjectiveReconstruction of oral and maxillofacial defects following resection of oral and maxillofacial malignant tumors is required to restore the patient's appearance and oral function. The aim of this study was to evaluate the application and value ofsoleus perforator flap from the lateral leg in repair of oral and maxillofacial defects.MethodsIn this retrospective study, ten patients with oral and maxil-lofacial malignancies who were admitted to the Department of Oral and Maxillofacial Surgery in Fuyang People's Hospital during the period from May 2015 to March 2019 were enrolled. The effect of soleus perforator flap from the lateral leg was ana-lyzed.At 1 month and 3 months after surgery, the recovery of oral function and donor sites, quality of life and surgical satisfaction were followed.ResultsAllpatients underwent operation successfully without skin flap necrosis or serious complications.At 3 months after surgery,voice function and swallowing func-tion were level 3. The scar hyperplasia was 1 case,donor itching1 case and paresthesia or dysfunction 0 case.Compared with those at 1 month after surgery, the scores at 3 months after surgery were increased using the University of Washington Quality of Life (UW-QOL) questionnaire(P<0.05). At 1 month and 3 months after sur-gery,patient satisfaction rateswere 80.00% and 90.00%, respectively.ConclusionThe soleus perforator flap from the lateral leg isideal for repairing oral and maxillofacial defects. The postoperative recovery of oral functio-nand donor sites is goodwith high quality of life and surgical satisfaction.

Cost-effectiveness Analysis of Hospital Rehabilitation and Hospital-family Rehabilitation in Children with Cerebral Palsy / 中国康复理论与实践

@#Objective To analyze the cost-effectiveness of hospital rehabilitation and hospital-family rehabilitation in children with cere-bral palsy. Methods From January to December, 2016, 60 cases of children aged one to three years with cerebral palsy were divided into hospital rehabilitation group and hospital-family rehabilitation group, with 30 cases in each group. The hospital rehabilitation group received rehabilitation of traditional Chinese and Western medicine treatment, including exercise therapy, physical therapy and Chinese Medical ther-apy; while the hospital-family rehabilitation group received family rehabilitation. The Gross Motor Function Measure (GMFM) and Pea-body Developmental Motor Scale-fine Motor (PDMS-FM) were used to evaluate the motor function and fine motor function before and af-ter treatment. Results The GMFM score was higher (t=5.333, P<0.001), and the total medical cost was higher (t=23.614, P<0.001) in the hospital rehabilitation group than in the hospital-family rehabilitation group. However, the cost of medical care was significantly lower for every 1-point increase in GMFM and visual-motion integration of PDMS-FM in the hospital rehabilitation group than in the hospital-family rehabilitation group (t>2.065, P<0.05). Conclusion The hospital rehabilitation model may be a more economical and effective treatment for younger age children with cerebral palsy, and the hospital-family rehabilitation model could be used as an effective complementary rehabili-tation model for this age group.

Cost-effectiveness Analysis of Hospital Rehabilitation and Hospital-family Rehabilitation in Children with Cerebral Palsy / 中国康复理论与实践

@#Objective To analyze the cost-effectiveness of hospital rehabilitation and hospital-family rehabilitation in children with cere-bral palsy. Methods From January to December, 2016, 60 cases of children aged one to three years with cerebral palsy were divided into hospital rehabilitation group and hospital-family rehabilitation group, with 30 cases in each group. The hospital rehabilitation group received rehabilitation of traditional Chinese and Western medicine treatment, including exercise therapy, physical therapy and Chinese Medical ther-apy; while the hospital-family rehabilitation group received family rehabilitation. The Gross Motor Function Measure (GMFM) and Pea-body Developmental Motor Scale-fine Motor (PDMS-FM) were used to evaluate the motor function and fine motor function before and af-ter treatment. Results The GMFM score was higher (t=5.333, P<0.001), and the total medical cost was higher (t=23.614, P<0.001) in the hospital rehabilitation group than in the hospital-family rehabilitation group. However, the cost of medical care was significantly lower for every 1-point increase in GMFM and visual-motion integration of PDMS-FM in the hospital rehabilitation group than in the hospital-family rehabilitation group (t>2.065, P<0.05). Conclusion The hospital rehabilitation model may be a more economical and effective treatment for younger age children with cerebral palsy, and the hospital-family rehabilitation model could be used as an effective complementary rehabili-tation model for this age group.

Pulmonary cryptococcosis in non-AIDS patients

OBJECTIVE: To investigate the clinical features, management, and prognosis of pulmonary cryptococcosis in non-acquired immunodeficiency syndrome (AIDS) patients. METHOD: 24 cases of pulmonary cryptococcosis with accurate pathological diagnosis were retrospectively studied. RESULTS: 15 male patients and nine female patients were diagnosed at the first affiliated hospital of Sun Yat-sen University from November 1999 to November 2011. The mean age at the time of diagnosis was 44.2 ± 11.3 years (range: 24 to 65 years). Among these patients, 13 had other comorbidities. 15 were symptomatic and the other nine were asymptomatic. The most common presenting symptoms were cough, chest tightness, expectoration, and fever. None had concurrent cryptococcal meningitis. The most frequent radiologic abnormalities on chest computed tomography (CT) scans were solitary or multiple pulmonary nodules, and masses or consolidations, and most lesions were located in the lower lobes. All patients had biopsies for the accurate diagnosis. Among the 24 patients, nine patients underwent surgical resections (eight had pneumonectomy via thoracotomy and one had a pneumonectomy via thoracoscopy). Five of the patients who underwent surgery also received antifungal drug therapy (fluconazole) for one to three months after the surgery. The other 15 only received antifungal drug therapy (fluconazole or voriconazole) for three to six months (five patients are still on therapy). The follow-up observation of 19 patients who had already finished their treatments lasted from two to 11 years, and there was no relapse, dissemination, or death in any of these patients. CONCLUSION: Non-AIDS patients with pulmonary cryptococcosis have a good prognosis with appropriate management.

An unusual presentation of thoracic para-aortic hematoma due to blunt trauma.

An 11-yr-old boy was admitted to the hospital with gradually aggravating acute abdominal pain along with nausea, vomiting and constipation for 5 days. The pain started after blunt trauma on the superior abdomen. He had normal laboratory tests and abdominal examination, but his chest radiograph showed infiltration in the right lung and an abnormal mass on the left diaphragm. Further investigation like computed tomography (CT) and magnetic resonance MR angiography, revealed an abnormal para-aotic mass located a mass located para-aortic above posterior to the left diaphragm with a well-defined margin. The abnormal mass was finally confirmed to be a hematoma with exploratory thoracotomy. The rarity of this kind of presentation is discussed for making an early and correct diagnosis.

Bicuculline inhibits airway remodeling in a murine model of chronic asthma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of bicuculline, a selective GABAA receptor antagonist, on airway remodeling in the murine model of chronic allergen-induced asthma.</p><p><b>METHODS</b>Forty BALB/C mice were randomized into 4 groups, namely the control group, asthmatic model (induced by ovalbumin sensitization and challenge) group, budesonide inhalation group and bicuculline inhalation group. The mice were sacrificed 24 h after the last ovalbumin inhalation, and the lungs were lavaged with PBS and the total cells, eosinophils and lymphocytes counts were examined. Periodic acid-Schiff (PAS) staining was used for counting mucin-positive goblet cells in the lung tissue, and Masson Trichrome staining was used to evaluate collagen deposition. GABAARbeta2 and VEGF were quantified by immunohistochemistry.</p><p><b>RESULTS</b>The numbers of the total cells, eosinophils and lymphocytes counts in BALF were significantly greater in the bicuculline group than in the control and budesonide groups (P<0.01), but comparable to those in the asthmatic model group (P>0.05). The airway collagen deposition in the bicuculline group was comparable to that in the control and budesonide group (P>0.05), but was significantly less than that in the asthmatic model group (P<0.05). Significant differences were found in the airway histological mucus index between the bicuculline group and the other 3 groups (P<0.05). The airway GABAARbeta2-positive cell percentage in the bicuculline group was significantly greater that those in the control and budesonide (P<0.01 and 0.05), but similar with that in the asthmatic model group (P>0.05). The percentage of pulmonary perivascular VEGF-positive cells in the bicuculline group was significantly greater in the control and budesonide groups (P<0.01 and P<0.05), but comparable to that in the asthmatic model group (P>0.05).</p><p><b>CONCLUSION</b>GABAARbeta2 is expressed in both the airway epithelium and smooth muscles. Bicuculline inhalation can effectively suppress collagen deposition with a stronger inhibitory effect on mucus hypersecretion than budesonide.</p>

CEOP regimen in the treatment for non-Hodgkin's lymphoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The aim of this study is to analyse the efficacy and toxicity of CEOP regimen in the treatment of non-Hodgkin's lymphoma (NHL).</p><p><b>METHODS</b>From January 1995 to December 2000, 121 patients with NHL were treated by CEOP regimen with or without radiotherapy for the involved field. The clinical characteristics, response, toxicity and long-term survival results were analysed retrospectively.</p><p><b>RESULTS</b>Of these 121 patients, 83 (68.6%) had B-cell NHL and 38(31.4%) peripheral T or NK-cell NHL; 55. 4% (67/121) had early disease (stage I or II), and 89.3% (108/121) had IPI score 0-2. The median age was 53 years (range: 7-79 yr). All patients were treated by CEOP regimen (totally, 471 cycles) with or without radiotherapy. The overall response (OR) rate in this series was 90.9% (110/121) with a complete remission (CR) rate of 71.9% (87/121); whereas the response rate of chemotherapy alone was 88.4% (107/121) with a CR rate of 67.8% (82/121). Major toxicity consisted of grade III-IV myelosuppression (11.9%), neutropenia (1.9%) and thrombocytopenia and anemia (1.1%). Alopecia was observed in 46.3%. However, cardiotoxicity was mild and reversible. Median follow-up duration in this series was 63 months (range: 2-116 months). The overall 1-, 3- and 5-year survival rate was 84.8%, 62.7% and 55.9%, respectively, with a median survival time of 85 months (2-118 months).</p><p><b>CONCLUSION</b>Our data show that CEOP regimen combined with or without radiotherapy for the involved field is effective and well tolerated by the patients with non-Hodgkin's lymphoma.</p>