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Maxillary defects result in esthetic and functional defects in patients. Several techniques are available for ma-xillary reconstruction. Herein, we present a case of maxillary reconstruction with medial femoral condyle periosteal flap by intraoral anastomosis. The characteristics of medial femoral condyle periosteal flap and the advantages of intraoral anasto-mosis are introduced.
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Humanos , Anastomose Cirúrgica , Estética Dentária , Fêmur , Maxila , Procedimentos de Cirurgia Plástica , Retalhos CirúrgicosRESUMO
Objective To provide reference for further perfection and revision of standards relevant to limb injury by comparing the evaluation results of different disability standards of long bone fracture. Methods Thirty cases were selected from the long bone fracture cases accepted by our institution in 2018. These cases include 5 cases of shoulder, elbow, wrist, hip, knee, ankle joints, respectively, to investigate the degree of loss of function of joints after long bone fracture. Disability evaluation was made according to Classification of the Impairment Related To Injury (hereinafter referred to as Classification), Assessment for Body Impairment of the injured in road traffic accidents (now repealed, hereinafter referred to as original Road Standard) and Identifying Work Ability-Gradation of Disability Caused by Work-related Injuries and Occupational Diseases (hereinafter referred to as Work Standard). The disability evaluation results of every domestic standard were compared with the joint damage rate of Guides to the Evaluation of Permanent Impairment (hereinafter referred to as GEPI). Results The functional loss rate of joints (except ankle) was 26%-48%,and the ankle functional loss rate was 51%-64%. The mean value of GEPI joint impairment rate of the joints was 13%-22%, with the fluctuation range less than 10%. The rate of level 10 disability was 100% according to the Classification. The rate of level 10 disability was 27%, the rate of level 9 disability was 6% and 67% were not disabled according to the original Road Standard. The rate of level 10 disability was 10% according to the Work Standard and 90% had a disability above level 10 (47% were classified as level 7 disability). Conclusion The people with limb joint dysfunction in this study had evaluation results with a smaller fluctuation range and better consistency according to the Classification and GEPI. The evaluation results according to the original Road Standard and the Work Standard has a less consistency. The Classification is more similar to GEPI and is more reasonable.
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Humanos , Avaliação da Deficiência , Pessoas com Deficiência , Medicina Legal/normas , Fraturas Ósseas , Articulação do Joelho , Articulação do PunhoRESUMO
The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation (PANP) was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP) from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients (18.37%) presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients (21.82%) in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed (P>0.05). It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.
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Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Sistema Nervoso Autônomo , Ferimentos e Lesões , Laparoscopia , Traumatismos dos Nervos Periféricos , Complicações Pós-Operatórias , Neoplasias Retais , Cirurgia Geral , Disfunções Sexuais Fisiológicas , Doenças UrológicasRESUMO
The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation (PANP) was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP) from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients (18.37%) presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients (21.82%) in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed (P>0.05). It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.
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<p><b>OBJECTIVE</b>To evaluate the efficacy of laparoscopic transanal coloanal anastomosis (modified Parks procedure) in sphincter-preserving surgery for low rectal carcinoma.</p><p><b>METHODS</b>Clinical data of 65 low rectal cancer patients undergoing laparoscopic modified Parks procedure from March 2009 to April 2012 in our department were reviewed retrospectively. Fecal continence, urination and sexual function were evaluated.</p><p><b>RESULTS</b>All the patients were followed up from 6 to 38 months after operation. Anastomotic leakage was found in 2 cases, anastomotic stricture in 3 cases, hepatic metastasis in 1 case. No local recurrence occurred. The ratio of satisfactory defecation function was 61.5% (40/65) in six months, 84.2% (48/57) in 1 year and 88.9% (40/45) in 2 years respectively. Urinary dysfunction was found in 7 patients (10.8%). Among 36 male patients, 7 (19.4%) presented erectile dysfunction and 10 (27.8%) ejaculation dysfunction. Among 29 female patients, sexual life of 19 (65.5%) was satisfactory.</p><p><b>CONCLUSION</b>Laparoscopic modified Parks procedure in sphincter-preserving surgery for low rectal cancer can increase the ratio of sphincter-preserving, and improve the functional outcomes of defecation, sex and urination.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Canal Anal , Cirurgia Geral , Anastomose Cirúrgica , Métodos , Colo , Cirurgia Geral , Seguimentos , Laparoscopia , Métodos , Neoplasias Retais , Cirurgia Geral , Estudos RetrospectivosRESUMO
<p><b>OBJECTIVE</b>To investigate the safety and efficacy of the transabdominal-hiatal approach of radical gastrectomy for the advanced proximal gastric cancer.</p><p><b>METHODS</b>The clinical data of 40 advanced proximal gastric cancer patients with involvement of distal esophagus admitted in Tongcheng People's Hospital from June 2003 to September 2006 were analyzed retrospectively. Patients included 27 men and 13 women with a mean age of 56.1 years (range: 37 to 76 years). The data were compared with those of 40 proximal gastric cancer patients undergoing standard thoracoabdominal approach (control group) during the same period.</p><p><b>RESULTS</b>As compared with the control group, the transabdominal-hiatal approach showed less blood loss [(181.3 ± 63.7) ml vs.(248.8 ± 79.7) ml], shorter operating time [(4.1 ± 0.6) h vs. (5.3 ± 0.7) h], shorter ICU stay [(6.5 ± 5.7) d vs. (19.4 ± 18.0) d] and shorter postoperative hospital stay [(14.0 ± 2.3) d vs.(18.7 ± 3.0) d] (all P<0.05). The complication rates of transabdominal-hiatal approach group and thoracoabdominal approach group were 7.5% (3/40) and 10.0% (4/40), and the 5-year survival rates were 51.3% and 60.0%, respectively (both P>0.05).</p><p><b>CONCLUSION</b>The transabdominal-hiatal approach of radical gastrectomy for proximal gastric cancer is safe and effective, which may substitute the standard thoracoabdominal technique.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seguimentos , Gastrectomia , Métodos , Estudos Retrospectivos , Neoplasias Gástricas , Cirurgia Geral , Resultado do TratamentoRESUMO
Objective To evaluate whether Loewenstein occupational therapy cognitive assessment (LOTCA) can be used in the diagnosis of postoperative cognitive dysfunction (POCD) by comparing it with mini-mental state examination (MMSE).Methods Thirty patients performed cardiac valve replacement surgery in our hospital from October 2010 to March 2011 were chosen; the cognitive function of these patients were neuropsychologically evaluated by MMSE and LOTCA 1 d before and 7 d after the surgery; the differences of accurately diagnostic rate on POCD,the scores and the time-consuming when MMSE and LOTCA were chosen were compared.Results Thirteen patients (43.33%) were diagnosed as having POCD by MMSE and 17 patients (56.67%) by LOTCA; the difference of accurately diagnostic rate on POCD was not statistically significant (x2=1.067,P=0.302).MMSE scores,LOTCA scores and scores of 4 subtests (motor praxis,visuomotor organization,operation of thinking,and attention and concentration) 7 d after the surgery was significantly decreased as compared with those 1 d before the surgery (P<0.05).MMSE scores were highly correlated with LOTCA scores (γ=0.711,P=0.005).Conclusion LOTCA can be used in the diagnosis and research of POCD.It can do a more comprehensive assessment than MMSE in cognitive function with longer times.
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<p><b>OBJECTIVE</b>To establish a nasopharyngeal carcinoma (NPC) cell line CNE1-pLVTHM/BART7 with stable ebv-miR-BART7 overexpression.</p><p><b>METHODS</b>The recombinant lentivirus pLVTHM/BART7 expression plasmid was packaged into mature lentivirus by 293FT cells and used to infect CNE1 cells. Flow cytometry was employed for sorting the GFP(+) cells. The efficiency of ebv-miR-BART7 overexpression was determined using qRT-PCR.</p><p><b>RESULTS</b>The recombinant lentivirus plasmid pLVTHM/BART7 was successfully constructed and verified by PCR and sequencing. The expression of ebv-miR-BART7 in CNE1 cells infected with the lentivirus pLVTHM/BART7 was significantly increased as compared with the negative control and the blank control cells.</p><p><b>CONCLUSION</b>The recombinant lentivirus vector pLVTHM/BART7 results in high and stable expression of ebv-miR-BART7 in infected CNE1 cells, which provides a useful cell model for further studies of the role of ebv-miR-BART7 in nasopharyngeal carcinoma.</p>
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Humanos , Carcinoma , Linhagem Celular Tumoral , Vetores Genéticos , Lentivirus , Genética , MicroRNAs , Neoplasias Nasofaríngeas , Genética , PlasmídeosRESUMO
<p><b>OBJECTIVE</b>To investigate the association of the IL-6 -572C > G polymorphism with the risk of prostate cancer (PCa) in the Chinese Han population in Jiangsu and Anhui area.</p><p><b>METHODS</b>We obtained peripheral blood genome DNA from 200 PCa patients and 279 age-matched PCa-free healthy controls, analyzed the site polymorphism of IL-6 -572C > G with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique, and studied the correlation of different genotypes with the susceptibility to PCa.</p><p><b>RESULTS</b>The subjects that carried the CCGG genotype had a risk of PCa 2.46 times that of the CC genotype carriers (95% CI = 1.41-4.29), and 2.47 times that of the CC/GC genotype carriers (95% CI = 1.47-4.17). This risk was significantly increased among the following subgroups of CCGG genotype carriers: age > 70 yr (OR = 3.06, 95% CI: 1.44-6.49), BMI > 23 kg/m2 (OR = 3.72, 95% CI: 1.79-7.74), no cigarette smoking (OR = 2.96, 95% CI: 1.30-6.72), alcohol drinking (OR = 2.73, 95% CI: 1.28-5.79), with a family history of cancer (OR = 6.67, 95% CI: 1.50-29.69).</p><p><b>CONCLUSION</b>In the Chinese Han population in Jiangsu and Anhui area, IL-6 -572C > G polymorphism is associated with the susceptibility to PCa, and GG might be a susceptible genotype to PCa.</p>
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Idoso , Humanos , Masculino , Povo Asiático , Genética , Estudos de Casos e Controles , China , Epidemiologia , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Interleucina-6 , Genética , Polimorfismo de Nucleotídeo Único , Neoplasias da Próstata , Epidemiologia , GenéticaRESUMO
The magnetic responsibility and antitumor effect of magnetic gemcitabine stealth nano-liposomes (MGSL) on breast cancer cell line MCF-7 in vitro and in vivo was evaluated. The magnetic response and targeting effect of MGSL in vivo were investigated. Morphological feature and ultrastructure changes of apoptosis of MCF-7 cells were observed. The effect of MGSL on proliferation inhibitory rate of MCF-7 cells was measured with MTT method. The FCM analysis was carried out to examine the cell cycle distribution and cell apoptotic rate. The antitumor effect on human breast cancer xenografts in nude mice was also studied. MGSL was able to converge at the targeting tissue under tridimensional magnetic field and the gemcitabine concentration around it increased, while the amount of gemcitabine in other organs decreased, such as in kidneys and heart. MCF-7 cell line was sensitive to MGSL and the cytotoxity was correlated with the loaded drug dose. The effect of MGSL on apoptosis of MCF-7 was obvious and the rate of apoptosis was 51.62%. The growth speed of tumor in the group of MGSL (+) significantly slowed down than that of other groups. MGSL prepared by reverse-phase evaporation method met with the demand of targeted delivery system, and it might be an effective antitumor agent.
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Animais , Feminino , Humanos , Masculino , Camundongos , Antimetabólitos Antineoplásicos , Farmacocinética , Farmacologia , Apoptose , Neoplasias da Mama , Patologia , Ciclo Celular , Linhagem Celular Tumoral , Proliferação de Células , Desoxicitidina , Farmacocinética , Farmacologia , Relação Dose-Resposta a Droga , Sistemas de Liberação de Medicamentos , Lipossomos , Química , Magnetismo , Camundongos Endogâmicos BALB C , Camundongos Nus , Nanopartículas , Transplante de Neoplasias , Distribuição Tecidual , Carga TumoralRESUMO
<p><b>OBJECTIVE</b>To construct a recombinant lentivirus RNA interference (RNAi) vector carrying hTERT gene, and to obtain the titer of the lentiviral stock for investigating the expression in the eukaryotic cells and the effect on the hTERT gene silencing in the eukaryotic cells.</p><p><b>METHODS</b>Two complimentary oligos of small interference RNA (siRNA) with hairpin structures targeting the hTERT gene and a negative control were synthesized, then ligated with pLVTHM vector and sequenced. The recombinant vectors were then transfected with viral packaging mix into T293 cells, viral supernatant was harvested to determine the titer. U87 cells infected by virus were harvested and the expression of hTERT, telomerase activity and apoptosis were detected by reverse transcription-PCR(RT-PCR), TRAP assay and flow cytometry separately.</p><p><b>RESULTS</b>Sequencing data showed that the constructed plasmids contained the correct sequences of hTERT siRNA transcript templates. A vector producing cell line T293 was established, and the titer for transfection was obtained. RT-PCR and TRAP flow cytometry analyses demonstrated that hTERT shRNA expression construct could suppress the expression of hTERT and telomerase activity and induce apoptosis.</p><p><b>CONCLUSION</b>A lentivirus RNAi vector targeting hTERT gene was successfully constructed, which decreased the expression of hTERT and telomerase activity effectively and induced apoptosis. It has set up a research platform for the gene therapy of tumors which take hTERT as the target.</p>
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Humanos , Sequência de Bases , Linhagem Celular , Citometria de Fluxo , Técnicas de Silenciamento de Genes , Métodos , Vetores Genéticos , Genética , Lentivirus , Genética , Dados de Sequência Molecular , Oligodesoxirribonucleotídeos , Genética , Metabolismo , Plasmídeos , Genética , Metabolismo , Interferência de RNA , RNA Interferente Pequeno , Genética , Metabolismo , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Telomerase , GenéticaRESUMO
<p><b>OBJECTIVE</b>To evaluate the effect of laparoscopic spleen-preserving operation for traumatic spleen rupture.</p><p><b>METHODS</b>From 1997 to 2003, 15 cases of traumatic spleen rupture were treated with laparoscopic spleen-preserving operation in our hospital. Nine cases had operation history in the middle and lower abdomen. ZT binding, electrocoagulation, fibrin and gelfoam tamping and suture repairing were used in patients with spleen rupture of grade I and grade II. Combined hemostasis was used for spleen rupture of grade III.</p><p><b>RESULTS</b>All patients did not need laparotomy during operation and no postoperative bleeding occurred. They were all cured and followed up for 3-12 months. Determination of immunoglobulins after operation showed normal, and spleen ultrasonic examination, CT and body state evaluations were all satisfactory.</p><p><b>CONCLUSIONS</b>Laparoscopy in the management of spleen trauma can be used in confirmed diagnosis and in determining the degree of spleen injury. For patients with stable vital signs laparoscopic spleen-preserving operation can be used. The laparoscopic spleen-preserving operation is safe in the treatment of traumatic spleen rupture.</p>
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Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seguimentos , Hematocele , Laparoscopia , Métodos , Tempo de Internação , Ruptura Esplênica , Cirurgia Geral , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To investigate the inhibitory effect and mechanism against the growth of human gastric carcinoma cell line HS-746T by the combination of the survivin antisense oligonucleotide (ASODN) and P53 gene and its mechanism.</p><p><b>METHODS</b>Gastric carcinoma cell line HS-746T was treated by P53 gene and survivin antisense oligonucleotide was designed. There were four regimen groups treated by different agents:ASODN alone, P53 gene alone and the combination of ASODN and P53 gene, blank control. Cell proliferative ability and cell growth were determined by cells counting and MTT. The expression of survivin mRNA and protein was detected by RT-PCR and Western blot respectively. Cell apoptotic index was detected by TUNEL.</p><p><b>RESULTS</b>ASODN alone, P53 alone and the combination of ASODN and P53 could inhibit not only the growth of gastric carcinoma cell, but also down-regulate the survivin mRNA and protein expression. The inhibitory effect was stronger, and the apoptosis index was higher in the combined transfection group than those in the other two single transfection groups.</p><p><b>CONCLUSION</b>The combination of survivin ASODN and P53 gene is more efficient to inhibit cell growth and induce apoptosis than that of agent alone.</p>
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Humanos , Apoptose , Linhagem Celular Tumoral , Proliferação de Células , Proteínas Inibidoras de Apoptose , Proteínas Associadas aos Microtúbulos , Genética , Oligonucleotídeos Antissenso , Genética , Farmacologia , Neoplasias Gástricas , Genética , Patologia , Transfecção , Proteína Supressora de Tumor p53 , GenéticaRESUMO
<p><b>OBJECTIVE</b>To summarize the reoperation experiences in treatment of massive rebleeding after subtotal gastrectomy for bleeding gastroduodenal ulcer.</p><p><b>METHODS</b>From 1980 to 2002, clinical data of 26 cases with massive rebleeding after subtotal gastrectomy for bleeding gastrorenal ulcer were analyzed retrospectively.</p><p><b>RESULTS</b>Preoperative gastroscopy was performed in 6 cases, intraoperative gastroscopy in 11, and preoperative superselective angiography in 2 cases. Eleven cases with left ulcer or post- bulb ulcer bleeding underwent resection of the left ulcer or longitudinal incision of the duodenal descending part and direct hemostasis. Thirteen cases with anastomotic stoma bleeding underwent local suture hemostasis or resection of the stoma plus Billroth II or Roux- en- Y gastrojejunostomy. Two cases with gastric bleeding received reexcision of the stomach remnant. Twenty- four cases (92.3% ) were cured and 2 cases (7.7% ) died of gastric bleeding.</p><p><b>CONCLUSION</b>Preoperative superselective angiography and intraoperative gastroscopy are beneficial to clarify the bleeding position and causes for massive rebleeding after gastrectomy. It is very important to select proper operative method to prevent postoperative rebleeding.</p>
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Angiografia , Gastrectomia , Hemorragia Gastrointestinal , Cirurgia Geral , Úlcera Péptica , Cirurgia Geral , Hemorragia Pós-Operatória , Cirurgia Geral , Estudos RetrospectivosRESUMO
<p><b>OBJECTIVE</b>To study the inhibitory effect and reasons of liposomes survivin antisense oligonucleotides (ASODN) on growth of human gastric carcinoma transplanted subcutaneously in nude mice.</p><p><b>METHODS</b>Human gastric carcinoma transplanted subcutaneously in nude mice model was established, and subsequently was divided randomly into six groups: control group, liposome group, sense oligonucleotide (SODN) group, 100, 200 and 400 nmol/L ASODN group. Different treatments were given respectively. The weight and volume of subcutaneous tumors were measured, and tumor growth inhibitory rate and decreased rate was calculated. The morphological changes of transplanted tumor cells were observed under light microscope. The expression of survivin was detected by immunohistology (SP). Changes of survivin gene transcription and protein expression were determined by western blot and RT-PCR.</p><p><b>RESULTS</b>Growth of the tumors was significantly inhibited in all ASODN groups as compared with that in the control, liposome and SODN group. The highest growth inhibitory rate in the 400 nmol/L group is 93%. The number of apoptotic cells of ASODN group increased and expression of survivin became weaken under the microscope. Liquified necrosis regions could be seen in 6 cases (6/12) of tumor tissues. The content of survivin mRNA and protein decreased in all survivin ASODN groups. The survivin protein expression of 400 nmol/L group was about 36.8% of the control group.</p><p><b>CONCLUSIONS</b>Survivin gene ASODN can inhibit the growth of human gastric carcinoma in nude mice by inducing cells apoptosis and decreasing the expression of survivin mRNA and protein.</p>
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Animais , Humanos , Masculino , Camundongos , Antineoplásicos , Farmacologia , Apoptose , Proteínas Inibidoras de Apoptose , Lipossomos , Camundongos Endogâmicos BALB C , Camundongos Nus , Proteínas Associadas aos Microtúbulos , Genética , Proteínas de Neoplasias , Genética , Transplante de Neoplasias , Oligonucleotídeos Antissenso , Genética , Farmacologia , RNA Mensageiro , Genética , Neoplasias Gástricas , Metabolismo , Patologia , TerapêuticaRESUMO
<p><b>OBJECTIVE</b>To evaluate the efficacy of early superselective angiography and embolization in the diagnosis and treatment of massive bleeding after gastrectomy.</p><p><b>METHODS</b>The clinical data of 28 patients with massive bleeding after surgery from 1980 to 2001 were retrospectively analysed. All patients underwent emergency angiography and 27 of them were treated by transcatheter embolization.</p><p><b>RESULTS</b>Bleeding was controlled in 26 of the 28 patients (93%), recurrent bleeding occurred in 1, an recognized bleeding in 1, and abdominal pain in 1. There was no death.</p><p><b>CONCLUSIONS</b>Transarterial embolization for massive bleeding after gastrectomy is safe and effective. It is suggested that early emergency angiography should be considered in all patients with massive gastrointestinal bleeding after gastrectomy.</p>