In deep inferior epigastric perforator (DIEP) flap breast reconstruction, diffuse venous congestion caused by non-pedicle causes, such as lack of effective communication between deep and superficial venous systems, is very rare. In this paper, a case of young woman who underwent DIEP breast reconstruction after breast cancer mastectomy was reported. Imaging findings showed the absence of bilateral dominant perforators and the lack of communication between the deep and superficial venous system. During operation, the superficial inferior epigastric vessels were dissected in advance. Indocyanine green angiography showed arterial perfusion insufficiency and venous congestion.The flap was successfully salvaged by supercharging/draining with superficial inferior epigastric vessels, preserving the abdominal function of the young patient to the greatest extent.

Objective:This study aimed to explore the clinical application value of the indication selection criteria for bi-pedicled deep inferior epigastric arterial perforator flap(DIEP) versus pedicled transverse rectus abdominis myocutaneous flap(TRAM) combined with DIEP for breast reconstruction.Methods:The clinical data of patients who underwent delayed bi-pedicled abdominal flap breast reconstruction after breast cancer surgery in the Department of Oncoplastic and Reconstructive Breast Surgery and Department of Mammoplasty, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2008 to April 2022 were retrospectively analyzed. According to the indications for each procedure, corresponding blood supply source was selected. Subsequently, patients were divided into two groups: bi-pedicled DIEP group and pedicled TRAM+ DIEP combined flap group according to the type of blood supply source. The indication selection criteria for pedicled TRAM+ DIEP combined flap was as follows: lack of two groups of recipient vessels; no dominant perforator in the abdominal donor site; previous abdominal liposuction or abdominal surgery with large dissection range and severe scar; patients were unable to tolerate prolonged surgery or had high risk factors for microsurgery. A comparison of breast reconstruction surgery characteristics was conducted between the two groups. Independent-samples t-test, rank sum test, Chi-square test and Fisher’s exact probability method were used to analyze various data including age, body mass index (BMI), time interval between breast cancer surgery and breast reconstruction surgery, history of radiotherapy, history of chemotherapy, history of smoking, history of lower abdominal surgery, history of hypertension, original surgical incision type, length and width of flap, hospitalization length, preoperative and postoperative conditions, as well as postoperative complications. Statistical significance was defined at P<0.05. Results:A total of 54 patients who underwent unilateral breast reconstruction were included in this study with a mean age of 42.2 years (range, 30-59 years). The pedicled TRAM+ DIEP combined flap group consisted of 21 patients with a mean age of 42.7 years (range, 33-56 years) while the bi-pedicled DIEP group comprised 33 patients with a mean age of 41.8 years (30-59 years). Out of the 54 patients, a total of 38 were eventually followed up, comprising 14 in the pedicled TRAM+ DIEP combined flap group and 24 in the bi-pedicled DIEP group. The average follow-up duration for the pedicled TRAM+ DIEP combined flap group was 42 months (range, 6-69 months). Abdominal bulge occurred in one patient, while another patient experienced abdominal hernia. The average follow-up duration for the bi-pedicled DIEP group was 47 months (6-179 months), with no reported cases of abdominal bulge or abdominal hernia. There were no statistically significant differences observed between the two groups regarding age, BMI, time interval between breast cancer surgery and breast reconstruction surgery, history of radiotherapy or chemotherapy, history of smoking, history of lower abdominal surgery, history of hypertension, original surgical incision type, length and width of flap, hospitalization length or time to ambulation (all P>0.05). However, there was a statistically significant difference noted in duration of surgery between the pedicled TRAM+ DIEP combined flap group and bi-pedicled DIEP group [6.0(5.5-6.5) hours vs. 8.5(8.0-8.8) hours] ( P<0.01). Comparison analysis revealed no statistically significant differences in terms of partial flap necrosis (0/21 vs. 1/33), abdominal incision dehiscence (2/21 vs. 2/33), abdominal bulge (1/14 vs. 0 /24) or abdominal hernia (1/1 vs. 0/24) between the two groups ( P>0.05). Conclusion:For patients who needed bilateral vascular pedicled lower abdominal wall for breast reconstruction, utilizing a pedicled TRAM+ DIEP combined flap did not increase surgical complication risks. The proposed indication selection criteria for using a pedicled TRAM + DIEP combined flap outlined in this study could serve as guidance when choosing methods for bi-pedicled abdominal flap breast reconstruction.

荷兰格罗宁根大学(University of Groningen)医学中心进行了一场特别的手术:古力仁·范·丹姆(Gooitzen van Dam)教授带领助手们进入手术室、关掉了手术台周围的全部灯光,只让一束白光照射到卵巢癌患者的病灶上,并通过3台CCD相机显像来指导手术进程.手术中,患者卵巢上显示出绿色荧光的部分全部被切除. 这是一项由荷兰、德国和美国的科学家联合研发的荧光标记肿瘤切除术,选择的肿瘤类型为卵巢上皮癌(EOC)形成的肿瘤,研究成果发表在《自然·医学》(Nature Medicine)上.卵巢癌早期并不会有明显的症状,所以被发现时大多已接近晚期,晚期卵巢癌患者的预期往往不好.

<正>做为磁传感器材料中的新星,硅已被广泛关注。章晓中教授让硅基磁传感器的工业化实现成为了可能。科技创新加上技术实现,使得这项技术的市场潜力不容小觑。每天早上,我们按时打开手机,更新每日的新闻内容;来到办公室,打开电脑开始一天的忙碌。做会议演示的时候,可能还会用U盘把幻灯片拷到公用电脑上。

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<正>用3D打印双光子聚合和生物功能化修饰制作出的毛细血管,具有良好的弹性和人体相容性,不但可以用于替换坏死的血管,还能与人造器官结合,部分取代药物研发中的实验动物。10月举行的德国生物科技展(Biotechnical Fair)上,一段被镊子轻轻夹起的毛细血管吸引了参会者的关注,这是用3D打印机"打印"出来的人造血管。