In this report, we present the results of an anatomic study on the dimensions of the pectoralis minor muscle and its neurovascular supply in 10 adult human cadavers, in attempt to evaluate the feasibility of microsurgical transplantation of a part of the muscle for thumb opposition reconstruction. A series of five patients consequently underwent thenar reconstruction with the pectoralis minor muscle flap from December 2004 to October 2006. The transferred muscle was reinnervated with the third lumbrical branch of the ulnar nerve. Follow-up assessment showed that the patients recovered functional opposition of carpometacarpal joint with 24 degrees of pronation, and a muscle power with M4 to M5. All patients were satisfied with the appearance of reconstructed thenar eminence. We recommend this new technique for thenar and opposition reconstruction in patients who have severe loss of thenar muscles, injury to the median nerve, and wish to improve the appearance of thenar eminence.
Background LncRNA POU3F3 (POU3F3) is overexpressed and plays oncogenic roles in esophageal squamous-cell carcinomas. LncRNA MEG3 (MEG3) has been characterized as a tumor suppressive lncRNA in different types of cancer. Our preliminary deep sequencing analysis revealed the inverse correlation between POU3F3 and MEG2 across melanoma tissues, indicating the interaction between them in melanoma. Therefore, this study was performed to investigate the crosstalk between POU3F3 and MEG3 in melanoma. Methods Tumor and adjacent healthy tissues collected from 60 melanoma patients were subjected to RNA extractions and RT-qPCRs to analyze the differential expression of POU3F3 and MEG2 in melanoma. In melanoma cells, POU3F3 and MEG2 were overexpressed to study the interactions between them. CCK-8 assays were performed to analyze the roles of POU3F3 and MEG2 in regulating melanoma cell proliferation. Results We found that POU3F3 was upregulated, while lncRNA MEG3 was downregulated in melanoma. Expression levels of POU3F3 and MEG3 were inversely correlated across tumor tissues. In vitro experiments showed that POU3F3 overexpression decreased MEG3 expression in melanoma cells, while MEG3 overexpression failed to affect POU3F3. POU3F3 overexpression increased melanoma cell proliferation, while MEG3 overexpression decreased melanoma cell proliferation. In addition, rescue experiments showed that MEG3 overexpression attenuated the enhancing effects of POU3F3 overexpression. Conclusion POU3F3 may promote melanoma cell proliferation by downregulating MEG3.
Objective: High ligation of great saphenous vein combined with laser in the treatment of varicose veins of lower limbs is a minimally invasive and efficient operation, which is widely used. However, there is less discussion on the risk control and management of this kind of operation. So the study was undertaken to identify the hidden dangers and risks and improve the safety of operation. Methods: 214 cases (201 patients) of lower extremity treated by high ligation of great saphenous vein combined with laser in varicose vein cavity were treated from January 2016 to December 2018. The complications, adverse events and treatment were analyzed. There were no great saphenous vein, root injury of great saphenous vein, guide wire entering deep vein, guide wire or cannula breaking or breaking, skin nerve burn, local skin and soft tissue thermal injury in the groin incision. The patients were followed up for 1 month to 3 years. Results: 30 cases (14.0%) had risk or adverse events. During the operation, there were 7 cases without great saphenous vein in the groin incision, 3 cases with root injury of great saphenous vein, 3 cases with guide wire entering deep vein, 1 case with guide wire breaking, and 1 case with cannula burning through and breaking. In the follow-up, 8 cases had local skin and soft tissue thermal injury, 3 cases had saphenous nerve burn, 2 cases had lower extremity deep vein thrombosis and 2 cases had recurrence operated again. Other patients had no adverse consequences. Conclusion: Open operation and intracavitary interventional treatment are better than single operation, but at the same time, they have double risks. During and after the operation, appropriate measures should be taken according to the causes to avoid serious consequences.
The ethics of Noddings' care is an ethical theory which discusses the responsibility, emotion, relationship and mutual care between people, which has strong applicability in the relationship between doctors and patients. Amputation has the function of disability and is also a great blow to the patients' psychology. Under the influence of traditional culture, Chinese people have a lower reception degree of this operation, and need to give more professional care. Besides the indication and necessity of amputation, the medical side should also consider the acceptance of patients and their families. This is related to the age and occupation, cultural customs, ideological cognition, economic situation of the patients, and not only the medical technology. In clinical work, we should fully recognize the necessity and limitation of this surgical treatment method, and pay attention to the advantages and disadvantages of amputation. This paper summarizes the effect of doctor-patient communication and clinical teaching of 22 amputated patients, discusses the use of Noddings' care ethics knowledge to realize the good communication between doctors and patients, and at the same time, the specific application methods of Noddings' care ethics are transferred to lower doctors, and finally achieve the equal and reciprocal interpersonal relationship among doctors, patients and students.
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