[Transplantation of bilateral superficial inferior epigastric artery perforator flap for breast reconstruction in a patient with unilateral breast cancer].

On May 14, 2020, a 37 year old female patient with unilateral breast cancer was admitted to Hunan Cancer Hospital. She underwent modified radical mastectomy for right breast cancer and free transplantation of bilateral superficial inferior epigastric artery perforator flap (weighed 305 g) for breast reconstruction. During the operation, the right inferior epigastric vascular pedicle was anastomosed with the proximal end of the right internal mammary vessel, and the left inferior epigastric vascular pedicle was anastomosed with the distal end of the right internal mammary vessel; the blood flow of the flap was good; the wound in the donor site of the abdominal flap was closed directly. The operation lasted for 9 hours. In the first 48 hours post operation, the flap showed mild elevation in perfusion over drainage, but no obvious edema or blister was observed, flap temperature was consistent with the surrounding skin, and the drainage volume out of drainage tube was only 40 mL. The blood supply of the flap was completely restored to normal 3 days post operation, the flap survived well, the donor site incision had no obvious tension, and the healing was smooth. After 2 months of follow-up, the donor site incision of abdomen healed completely, only linear scar was left, and the reconstructed breast had a natural appearance; the patient planned to perform further nipple reconstruction and contralateral breast mastopexy. This case suggests that autologous breast reconstruction can be performed using bilateral superficial inferior epigastric artery perforator flaps under certain circumstances to minimize donor site injury to the greatest extent.

Changes in macular vascular density and retinal thickness in young myopic adults without pathological changes: an OCTA study.

OBJECTIVE: The aim of the study was to quantify the macular vascular density and retinal thickness in the eyes of young myopic people with myopia without pathological changes using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: In this cross-sectional study, 160 eyes of 80 myopia subjects without pathological changes were classified into three groups: mild myopia (N=40 eyes), moderate myopia (N=66 eyes), and high myopia (N=54 eyes). Macular vascular density (VD), retinal thickness, area of the foveal avascular zone, the flow area of the outer retina and choriocapillaris (CC) were measured using OCTA. The effects of other confounding factors including axial length, the spherical equivalent, and some systemic factors (blood pressure, height, weight, etc.) were also considered. RESULTS: As the severity of myopia increases, the CC flow area decreased (p=0.029). The superficial VD in the temporal, superior, nasal, and inferior regions was significantly lower in high myopia group compared to moderate and low myopia groups (all p<0.001). With increasing myopia, a significant reduction of deep VD was found in the superior region of the macula (p=0.007). In the fovea, there was no difference in the superficial or deep VD across groups (p=0.268 and p=0.413, respectively). Parafoveal retinal thickness was thinnest in the high myopia group and thickest in the mild myopia group (all p<0.05). The fovea was thickest in the high myopia group and thinnest in the mild myopia group (p=0.030). CONCLUSIONS: In young myopic people without pathological changes, superficial VD and retinal thickness decreased with myopia progression, except in the fovea. The CC flow area decreased with increasing myopia.

Is aspirin use associated with age-related macular degeneration? A meta-analysis.

WHAT IS KNOWN AND OBJECTIVES: Aspirin is one of the most widely used medications in the world. The evidence on its effect on the risk of age-related macular degeneration (AMD) appears inconsistent across different types of studies. The aim of this meta-analysis was to evaluate the association between aspirin use and the risk of AMD. METHODS: Relevant studies were searched using databases including PubMed, EMBASE, Cochrane Library and MEDLINE up to March 2014. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated by random-effects or fixed-effect models. The heterogeneity was assessed by the inconsistency index (I(2) ). The publication bias was evaluated by Begg's funnel plot and Egger's weighted regression. Sensitivity analysis was also performed in different ways. RESULTS: Ten eligible studies including 180 834 individuals based on the inclusion criteria were analysed in this meta-analysis. The pooled RR for the aspirin use on the risk of AMD was 1·137 (95% CI, 1·003-1·289; I(2) , 68·4%). The pooled RR for the aspirin use on the risk of early and late AMD was 1·19 (95% CI, 0·92-1·53; I(2) , 82·6%) and 1·22 (95% CI, 0·87-1·72; I(2) , 55·7%), respectively. In different types of late AMD, the pooled RR was 1·95 (95% CI, 1·40-2·72; I(2) , 27%) for neovascularization and 0·84 (95% CI, 0·62-1·15; I(2) , 0%) for geographic atrophy. The pooled RR in studies with standardized AMD classification was 1·307 (95% CI, 1·006-1·698; I(2) , 79·2%). WHAT IS NEW AND CONCLUSION: This meta-analysis updates similar reviews that included studies with various types of biases. A rigorous analysis shows a weak but statistically significant association between aspirin use and the risk of AMD; a result which is different to that previously reported.

[High-level production of poly (3-hydroxybutyrate-co-3-hydroxyvalerate) by feb-batch culture of Alcaligenes eutrophus].

Fermentation strategies for production P (3HB-co-3HV) from glucose and propionic (or valeric) acid by Alcaligenes eutrophus were studied. During the culture, we controlled pH of the broth by feeding precusors of 3HV- propionic or valeric acid after Ammonia feeding stopped. When propionic acid were used as the precusor, for 50 hours, we obtained a cell dry weight, a P(3HB-co-3HV) concentration, a P(3HB-co-3HV) content and a 3HV fraction of 149.9 g/L, 124.9 g/L, 83.3% and 12.4 mol%, respectively, with a PHA productivity of 2.50 g h-1 L-1. When valeric acid were used as the precusor, for 45 hours, we obtained a cell dry weight, a P(3HB-co-3HV) concentration, a P(3HB-co-3HV) content and a 3HV fraction of 160.2 g/L, 119.0 g/L, 74.2% and 17.7 mol%, respectively, with a PHA productivity of 2.64 g h-1 L-1. Prior to this study, it hasn't been reported to obtain such high level productivity and 3HV fraction at the same time by Alcaligenes eutrophus.