[Application of "tennis racket" flap with fascial pedicle on the healthy chest for the radiation ulcer after surgical treatment of breast carcinoma].

OBJECTIVE: To introduce the application of "tennis racket" flap with fascial pedicle on the healthy chest for radiation ulcer after surgical treatment of breast cancer. METHODS: The " tennis racket" flap was designed on the healthy chest along the cartilage with fascia pedicle near the sternum. 9 cases were treated. The flaps size ranged from 5.0 cm x 3.5 cm to 13 cm x 11 cm with pedicle size of 2-8 cm in length and 2.0-3.0 cm in width. RESULTS: All the 9 flaps survived completely with satisfactory appearance. The patients were followed up for 2 months to 3 years without ulcer reoccurrence. CONCLUSIONS: The "tennis racket" flap has a slender fascial pedicle without major blood vessel. It has the advantages of good flexibility for rotation and large flap size for the reconstruction of the radiation ulcer after surgical treatment of breast cancer.

Analysis on Application Rationality of Anti-fungal Agents for Deep Fungal Infection in Inpatients in a Top Three Hospital / 中国药师

Objective:To investigate the rationality of anti-fungal agents for deep fungal infection used in one hospital and the effects of national rectification of antimicrobial drugs. Methods: The retrospective analysis method was used to survey the inpatients administrated anti-fungal agents for deep fungal infection from April 2010 to Mard 2012, and assessed the rationality. Results:The ir-rational utilization of anti-fungal agents for deep fungal infection included loading dosage lack during the treatment,inappropriate loading dosage and administration frequency. The irrational utilization of anti-fungal agents for deep fungal infection was decreased significantly (P<0. 05)after the national rectification of antimicrobial drugs. Conclusion:After the national rectification of antimicrobial drugs, the hospital can amtrol the irrational use of anti-fungal agents to some extent, while still needs more management and education.

Effect of IL-1β-511 genetic polymorphism on postoperative analgesia with fentanyl / 中华麻醉学杂志

Objective To investigate the effect of IL-1β-511 genetic polymorphism on postoperative analgesia with fentanyl. Methods Two hundred and fifty ASA Ⅰ or Ⅱ patients of Han nationality (native of Henan province) aged 20-50 yr undergoing elective abdominal total hysterectomy or myomectomy under general anesthesia were enrolled in this study. The polymorphic sites of the IL-1β-511 allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism. The patients were assigned into 3 groups according to their genotypes: group wild homozygote; group mutation hetorozygote and group mutation homozygote. Anesthesia was induced with midazolam, remifentanil, propofol and succinylcholine and maintained with propofol, remifentanil and atracurium. The patients were mechanically ventilated after tracheal intubation. The pain was assessed using VAS score after the patients recovered from anesthesia. When VAS score was ＞ 3 the patients were given fentany120 μg every 5 min until VAS score decreased to ≤ 3. PCIA with fentanyl was then started. The PCIA solution contained fentanyl 1.0 mg and droperidol 5mg in 100 ml of normal saline. The PCA pump was set to deliver a background infusion of 0.5 ml/h and a bolus dose of 2 ml at 5 min lockout interval. The VAS score was maintained at ≤3.The amount of fentanyl consumed during 24 h of PCIA was recorded. Results There was no significant difference in the amount of fentanyl consumed during the 24 h PCIA among the 3 groups. Conclusion IL-1β-511 genetic polymorphism is not the factor contributing to the individual variation in the patient' s response to postopertive analgesia with fentanyl, indicating that the pain within 24 h after operation is not related to the inflammatory factors.