OBJECTIVE In order to reduce the complication of the transposition of superficial cervical artery skin flap for the repair of neck defect, the method of pre-expanded skin flap was designed, and its clinical result was observed. METHODS From March 1995 to October 1997, 12 cases with cicatricial contracture of the neck were treated by the following methods, preexpanded superficial cervical artery skin flap, and then transposed it for the reconstruction the cervical scar after burns. There were 8 males and 4 females and the age ranged from 6 to 32 years. A maximal size of flap was 35 cm x 14 cm and a minimal size was 16 cm x 7 cm. RESULTS All the flaps were survived except one, which partial necrosis occurred in the tip. Postoperative follow-up for 6 months to 3 years showed that the physiological angle of cervico-mandibular angle was recovered and the appearance of flap was satisfactory without swelling and contracture. CONCLUSION The preexpanded superficial cervical artery skin flap has many advantages, and it is particularly suitable for reconstruction of severe cervical contracture after extensive burns.
ObjectiveTo summarize the current status of research in nutritional support for glutamine after hepatectomy.MethodThe literatures on nutritional support of glutamine after hepatectomy in recent years were reviewed by searching domestic and foreign literatures.ResultsThe administration of glutamine up-regulated the expression of liver regeneration genes after partial hepatectomy in malnourished rats, and then stimulated cell mitosis by paracrine and endocrine cells, affecting the uptake of amino acids by hepatocytes and intestinal cells, and promoting hepatocyte proliferation. In clinical applications, glutamine could improve postoperative liver function and immune function, reduce the incidence of infectious complications, then relatively shorten the length of hospital stay, and improve the clinical outcome of patients.ConclusionGlutamine is beneficial to the recovery of liver function and has clinical application value.
ObjectiveTo systematically evaluate the effect of different enteral nutrition timing on patients with pancreaticoduodenectomy.MethodsPubMed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP databases were searched to collect RCTs for nutritional support in pancreaticoduodenectomy patients. The search time was established until March 1 2019. After two independent investigators conducted literature screening, data extraction, and evaluation of the risk of bias in the included studies, a meta-metabolic analysis was performed using the R 3.5.3 software gemtc package, JAGS 3.4.0, and Revman software.ResultsA total of 8 RCTs were included, for a total of 825 patients. The results of reticular meta-analysis showed that there was no significant difference in the duration of hospitalization for patients with pancreaticoduodenectomy, between the enteral nutrition supported at different timing. The results of the ranking probability map suggested that preoperative enteral nutrition was a better option for supporting nutrition in patients with pancreaticoduodenectomy, secondly, timing to give was 24–48 hours after operation.ConclusionsAccording to the results of mesh meta-analysis and probabilistic ranking, the nutritional status of patients is corrected before surgery, and the effect of enteral nutrition is better than other nutritional support methods. Secondly, enteral nutrition should be given at 24–48 hours after operation in combination with ESPEN and ERAS recommendations.
目的 探讨血管内皮生长因子（VEGF）及受体Flt-1蛋白表达与卵巢恶性肿瘤临床病理和预后的关系。 方法 2000年1月-2004年6月，以SABC免疫组织化学方法检测48例卵巢恶性肿瘤组织中VEGF及其受体Flt-1蛋白的表达。 结果 VEGF和Flt-1蛋白表达与卵巢恶性肿瘤的病理学类型、分化级别及临床分期无明显相关性（P＞0.05）。有淋巴结转移者VEGF和Flt-1蛋白的表达阳性率均明显高于无淋巴结转移者（P＜0.05）。 VEGF 和Flt-1共同表达者平均总生存期为27.88个月，明显短于没有共同表达者的36.04个月（95%CI 为33.42～38.65，P=0.022 3）。 结论 VEGF和Flt-1蛋白表达与卵巢恶性肿瘤的淋巴结转移相关，可作为预测肿瘤转移及预后的指标。
Objective To investigate the expressions of activating transcription factor 3 (ATF3) and ATF4, and their effects on γ-glutamylcysteine synthetase (γ-GCS) in lung tissues of patients with chronic obstructive pulmonary disease (COPD). Methods Non-cancerous lung tissue specimens ( 5 cm or above away from tumor) were collected from 40 lung cancer patients who underwent pulmonary lobectomy between December 2008 and December 2009. The patients were divided into a COPD group and a control group according to whether they were complicated with COPD. The clinical data were collected including the history in detail, physical examination, chest X-ray or lung CT, and pulmonary function test. The mRNA and protein expressions of ATF3, ATF4, and heavy subunit of γ-GCS (γ-GCS-HS) in lung tissues were detected by in situ hybridization and immunohistochemistry. At the same time, the interaction between ATF3, ATF4 and γ-GCS-HS protein was investigated by co-immunoprecipitation method. The correlation of ATF3 and ATF4 with γ-GCS-HS was analyzed. Results The mRNA and protein expressions of ATF3, ATF4 and γ-GCS-HS in lung tissues of the COPD group were strongly positive, and significantly higher than those in the control group (P＜0.01). The co-immunoprecipitation showed that ATF3 and ATF4 antibodies could cross the clear protein bands in the immune precipitation captured by γ-GCS-HS, and the intensity in the COPD group was significantly enhanced than that in the control group (P＜0.01). Correlation analysis showed that the protein expressions of ATF3 and ATF4 were significantly positively correlated with the mRNA and protein expression of γ-GCS-HS (allP＜0.01). The protein expressions of ATF3, ATF4 and γ-GCS-HS in lung tissues were positively correlated with FEV1%pred and FEV/FVC (P＜0.01). Conclusions Oxidative stress induces overexpression of ATF3 and ATF4 which may paly role in the pathogenesis of COPD. ATF3 and ATF4 may play antioxidative effect by affecting the mRNA and protein expression of γ-GCS.