Vascular pressurisation and super-reflux techniques applied in free anterolateral thigh flap / 中华显微外科杂志

Objective:To investigate the clinical effect of vascular pressurisation and super reflux on free anterolateral thigh flap (ALTF).Methods:From January 2017 to September 2021, the Department of Hand and Foot Microsurgery, the Second Affiliated Hospital of Hainan Medical College had treated 31 cases of soft tissue defects of the limbs. The patients were 23 males and 8 females, aged 4-76 years old at 40 years old in average. All the patients received transfer of free ALTFs carrying 2 groups of blood vessels of the descending and oblique branches of lateral circumflex femoral artery (LCFA). The vascular pressurisation and super-reflux techniques were applied in wound repair. Soft tissue defect area 7 cm × 5 cm-22 cm × 10 cm. The sizes of flaps were 8 cm×6 cm-23 cm×11 cm. All the donor sites were sutured directly. Fifteen patients had inner flap pressurisation (or super-reflux) and the rest of 16 patients had external flap pressurisation (or super-reflux). After surgery, scheduled follow-ups were conducted through outpatient clinic, telephone and WeChat reviews or home visits to evaluate the efficacy of wound repair.Results:All the 31 flaps survived, except 2 flaps that had mild infection after surgery. The wounds of donor and recipient sites healed completely. The time of follow-up was 3-55 months. The skin of flaps achieved good texture, colour, lustre and appearance. TPD of the flaps ranged 7-12 mm.Conclusion:Vascular pressurisation and super reflux technique are stable and reliable in the clinical application of free ALTF to repair soft tissue defects of limbs.

Clinical characteristics of hepatic flare and efficacy of antiviral therapy in pregnant women with chronic hepatitis B virus infection / 中华肝脏病杂志

Objective@#To analyze the clinical characteristics of hepatic flare and evaluate efficacy of antiviral treatment in pregnant women with chronic HBV infection.@*Methods@#A single-center, open-label, prospective study was conducted, and pregnant women with chronic HBV infection were enrolled. Liver function, HBV serum markers and HBV DNA of pregnant women with chronic HBV infection were reviewed during every 4 to 12 weeks of gestation period. The proportion and clinical characteristics of hepatitis flare during pregnancy were observed. Logistic regression analysis was used to predict hepatic flare in pregnant women with chronic HBV infection. Antiviral therapy with telbivudine (LdT) or tenofovir dipivoxil (TDF) was used to treat hepatic flare during pregnancy. Sequential entecavir (ETV) or TDF was applied after the delivery. Treatment course and drug withdrawal in pregnant women with hepatic flare was the same as those of the general patients with chronic hepatitis B. Liver function, HBV serum markers and HBV DNA were measured in pregnant women with hepatic flare at different time points (4, 12, 24 and 52 weeks). A t-test was used to compare the hepatic flare in pregnant women with and without hepatitis group. HBsAg and HBeAg were used to quantify the receiver operating characteristic (ROC) curve of pregnant women with hepatic flare during pregnancy. Area under the ROC curve was used to calculate the optimal cut-off value corresponding to the maximum sensitivity and specificity of the ROC curve.@*Results@#Of the 220 pregnant women with chronic HBV infection, 55 (25%) had hepatitis flare during pregnancy and received antiviral treatment. Among the 55 women with hepatic flare during gestation, 47 (85.46%) had hepatic flare in the mid-second trimester (12-24 weeks); average peak value of alanine aminotransferase (ALT) was 220.62 U/L, and the average peak value of ALT in 32 cases (58.18%) of pregnant women with hepatic flare was between 2–5 × ULN. HBsAg and HBeAg quantification were significantly lower in pregnant women with hepatic flare during pregnancy than with non-hepatitis (t = -3.745, P < 0.001; t = -2.186, P = 0.030). Multivariate logistic regression analysis showed that pregnant women with HBeAg < 3.065 log10 s/co were 7.576 times more likely to have hepatic flare during pregnancy (95% confidence interval: 3.779-15.190). ALT normalization, undetectable HBV DNA levels, HBeAg loss and HBeAg seroconversion in 55 pregnant women with hepatic flare at 52-week treatment was 100% (55/55), 74.55% (41/55), 47.27% (26/55) and 41.82% (23/55), respectively. HBsAg quantification at 52 weeks was significantly lower than baseline HBsAg quantification (3.32 + 0.37) log10 IU/ml and (3.95 + 0.40) log10 IU/ml; t = 8.465, P < 0.001).@*Conclusion@#Hepatic flare often occurs in the second trimester of pregnancy in pregnant women with chronic HBV infection and baseline HBeAg quantification is an independent predictor of hepatic flare. HBeAg seroconversion rate increased at 52 weeks after antiviral therapy.

Study on service demands towards Institute of Postpartum Care / 中国实用护理杂志

Objective To investigate the maternal attitude and demands for Institute of Postpartum Care in order to provide targeted services.Methods 285 women were a investigated about maternal attitude and demands towards Institute of Postpartum Care with self-designed questionnaire.Results 97.9％ (279/285) women thought sitting the month (puerperal period) was very important,50.2％ (143/285)women were interested in Institute of Postpartum Care.They thought the main three advantages were energy saving,medical expertise and technology and avoidance of family conflicts;The three major issues were high price,lack of monitoring mechanism and unfamiliar environment and less family company;33 items of services demands over four points accounted for 78.6％,the three modules with highest scores were cleaning services scored 4.64±0.47,newborn services scored 4.45±0.41,consultation service scored 4.41:±0.53.Conclusions Professional postnatal care services have been a trend and social need,and a large proportion of women have great interest and demand on Institute of Postpartum Care which should make full use of its concentrate resources,and provide specific services according to maternal demands for services.It is urgent to build unified service standards and evaluation indicators to improve service quality.

lnterleukin-18 inhibits experimental choroidal neovascularization and its potential therapeutic applications / 中华眼底病杂志

Interleukin-18 is an inactive precursor which lacks a signal peptide,it has a role inregulating retinal pathological angiogenesis.It also inhibits experimental choroidal neovascularization (CNV)via interferon-γand thrombospondin-1.Currently little is known about its mechanisms of inhibition forCNV,may be speculated to be due to effects of anti-angiogenesis,down-regulates vascular permeability andlower vascular endothelial growth factor (VEGF) levels via directly acting on the vascular endothelial celland epithelial cells.Exogenous administration of mature recombinant interleukin-18 has no adverse effect onretinal pigment epithelial cell viability.In addition,the anti-VEGF role of interleukin-18 is tested to be safeand effective for humans.Interleukin-18 alone or in combination with anti-VEGF shows to be a goodprospect for improving the prognosis of experimental CNV.However,more large clinical studies arerequired to confirm the exact efficacy of interleukin-18 for CNV.

The association between obstructive sleep apneahypopnea syndrome and glaucoma:a Meta analysis / 中华实验眼科杂志

Background Studies have showed an increasing prevalence of glaucoma in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).However,this view remains controversial.Objective This Meta analysis was to assess whether there is an association between glaucoma and OSAHS.Methods A systematic search in PubMed database was carried out with the subject headingssleeping apnea andglaucoma.The literature type was limited to cases-controlled studies and prospective cohort studies with the publishing duration from January 1,1982 to January 30,2015 in English.The risk of glaucoma among OSAHS patients was analyzed,and Review Manager 5.2 was applicated for Meta analysis.The pooled odds ratio (OR) and 95％ confidence interval (CI) was calculated to assess the strength of the association.Results Twelve independent retrospective casescontrolled studies were included in this review,including 11 592 subjects in the OSAHS group and 25 931 subjects in the control group.The study quality was scored 6-8 by Newcastle-Ottawa Scale which was acceptable.The random effects model was accepted because of the heterogeneity among the studies (x2=34.20,P＜0.05,I2 =68％).The prevalence of glaucoma was higher in the OSAHS group than that in the control group (OR =1.87,95％ CI:1.21-2.90,Z=2.82,P＜0.05).The subgroup analysis of OSAHS showed that the OR (95％ CI) of mild,moderate and severe OSAHS groups versus control group was 3.61 (0.56-23.43),4.17 (0.47-36.91) and 6.95 (1.14-42.26),respectively.Sensitivity analysis confirmed that the OR value fluctuated in 1.74-2.16 and closed to 1.87.Funnel graphy exhibited a asymmetry appearance among the literatures,which suggested a possible publication bias.Conclusions OSAHS is one of the risk factors of glaucoma.The serious OSAHS is associated with an increased risk of glaucoma.

Expression of Survivin, PTEN and its relationship with cell apoptosis in brain astrocytomas / 肿瘤研究与临床

Objective To investigate the cell apoptosis and the expression level of its related gene Survivin, PTEN. Methods Apoptotic cells and bodies were detected by TUNEL. Immunohistocbemical stains were performed to examine the expression of Survivin, PTEN and Ki-67. The software package SPSS 10.0 was used for statistical analysis. Results The Survivin positive rate in 73 tumors was 64.4 %, and there was significant negative correlation between Survivin weighted score and AI (r=-0.85,P<0.01). The mean AI of survivin-positive tumors was lower than that of Survivin-ncgative tumors(P=0.035). The PTEN positive rate in 73 tumors was 72.6 %, there was positive correlation between PTEN weighted score and AI (P=0.026). The mean AI of PTEN-positive tumors was higher than that of PTEN-negative tumors (P=0.034). There was significant negative correlation between AI and pathological grade and positive correlation between PI and pathological grade(r=-0.432, P=0.001, r=0.729, P<0.01). Conclusion Cell apoptosis was affected by some factors. AI was associated with the expression of Survivin and PTEN.

Correlation between expression of COX-2,Ki-67 and neoadjuvant chemotherapy in breast cancer / 中国医师进修杂志

Objective To study the correlation between expression of COX-2,Ki-67 and neoadjuvant chemotherapy in breast cancer.Method COX-2 and Ki-67 were examined by immunohistochemical staining in 48 breast cancer samples.Results The overall response rate and clinical benefit rate to neoadjuvant chemotherapy were 70.8% and 95.8%,respectively.The expression of COX-2 and Ki-67 after the chemothempy [41.7% and (33.23±18.11)%] was significantly lower than those in prechemotherapy [62.5% and (46.81±23.17)%],P<0.05.Ki-67 index Was higher in COX-2 positive tumom than that in the COX-2 negative ones before and after neoadjuvant chemotherapy,P<0.01.The effect of neoadjuvant chemotherapy had a significantly negative correlation with COX-2 expression.Patients with high expression of Ki-67 were more likely to respond to treatment.Conclusion The expression of COX-2 and Ki-67 as molecular markers could be a guide for chemotherapy and prediction for neoadjuvant's response to chemotherapy in breast cancer.

Clinical and pathological characteristics of benign metastasizing leiomyoma / 中国癌症杂志

Background and purpose: About 20 cases of BML have been reported in the literature,they occurred in females with history of uterus leiomyoma.BML appears as a histopathologic benign smooth muscle tumor located far from the uterus,often in the lungs.Firstly,it should be confirmed as originating from smooth muscle by immunohistochemistry,Secondly,its primary tumor should be confirmed as benign,with mucoid degenenation,it also should be distinguished from myxoid leiomyosacroma.Methods:We report a case of benign metastasizing leiomyoma,study its clinical,histopathologic and immunohistologic features,discuss the diagnosis and differential diagnosis and give a review of the related references.Results:The case occurred in a forty-two year old female who was found to have bilateral lung nodules after hysterectomy of her uterus leiomyoma six years ago.An open lung biopsy revealed the nodules to consist of proliferating smooth muscle cells with a histopathologic feature similar to her uterus leimyoma,consistent with the diagnosis of BML.Positive staining of estrogen and progesterone receptors was detected in both the uterus leiomyoma and the metastasizing lesions.No significant increase or enlargement of the lung nodules were found seven months after the operation with no therapy except taking Chinese traditional medicine.Conclusions:BML is a rare entity usually occurring in females with history of uterus leiomyoma.It appears as a histopathologic benign smooth muscle tumors distant from the uterus.It is hormone dependent and progresses slowly.

Effect of praziquantel on schistosomal ovum granuloma and hepatic fibrosis Ⅰ Effect of praziquantel on schistosomal ovum granuloma in the lung of mice / 中国血吸虫病防治杂志

Objective To explore the effect of praziquantel on schistosomal ovum granuloma in the lung of mice.Methods Forty-eight mice were divided into 4 groups.Group A:first,the mice were injected with schistosomal ova hypodermicly in abdomen and 10 days later,injected with schistosomal ova intravenously in the cauda;Group B:in addition to the injection of schistosomal ova as the same of Group A,the mice were administered with praziquantel [300 mg/(kg?d)] for 3 days from the last day of the intravenous injection of the ova;Group C:in addition to the injection of schistosomal ova as the same of Group A,the mice were administered with praziquantel(75 mg/kg,B.i.d.)for 5 days weekly until the mice were sacrificed;Group D:the same as Group C but praziquantel was given to the mice from the 29th after the intravenous injection of the ova.Three mice of each group were sacrificed on the 7th,14th,28th,56th day after the intravenous injection of the ova and the lung tissues were fixed with formalin and the slices were HE stained.Fifteen-thirty pieces of schistosomal ovum granuloma were examined and their areas were measured and the mean areas of each group were calculated and compared.Results On the 7th,14th and 28th days after the intravenous injection of the ova,the mean area of schistosomal ovum granuloma in Group C was significantly less than that in Group A,and there was a significant difference between the two groups,P 0.05.On the 56th day,the mean areas of schistosomal ovum granuloma in Group B,C,D were significantly less than that in Group A,all P