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Objective:To observe and summarise the clinical effect of free groin flap in repairing of soft tissue defects in extremities, and to explore the selection of main vessel in a flap.Methods:From January 2018 to January 2021, 146 patients with soft tissue defects in extremities were treated with free groin flaps in the Department of Hand and Microsurgery, Guangxi Guilin Xing'an Jieshou Orthopaedic Hospital. There were 126 patients with traumatic wound and 20 with chronic ulcer. In addition, 86 of the patients with bone fracture and exposure of internal fixator, 18 with tendon, nerve or artery injuries or defects. There were 6 patients with severe infection and other 3 with deep dead space. The sizes of wound ranged from 2.0 cm×3.0 cm to 25.0 cm×6.0 cm. The flap was the same size as the wound and not enlarged. Firstly, the superficial branch of superficial iliac circumflex artery was explored as the axial artery for all the flaps, then the blood supply vessels of the flap were selected according to the availability of the axial artery. The size, course, adjacent and possible length to be freed of the axial artery and the accompanying veins of a flap were recorded. The donor sites were directly sutured and closed. All patients were included in the postoperative follow-up at outpatient clinic.Results:Free groin flap were used to repair the wounds in all patients. However, the main blood supply vessel of the flap was not constant, and it was often required to adjust the way of flap harvesting. Superficial circumflex iliac artery was taken as the axial vessels in 141 patients (96.6%), among them, 133 cases(94.3%) had the superficial branch as the axis and 5 cases (3.6%) had deep branch as the axis. Three patients (2.1%) had the bone and soft tissue defects reconstructed with vascularised iliac mosaic osteocutaneous flap with superficial circumflex iliac artery as axial vessel and 5 cases(3.4%) had the superficial epigastric artery as axial vessel. The axial arteries were measured as follow: the superficial branch of the superficial circumflex iliac artery was 0.5-0.9 mm in diameter and 7.0-9.0 cm in length, the outer diameter of the deep branch was 1.2-1.4 mm and 9.0-11.0 cm in length, and the outer diameter of superficial epigastric artery was 1.0-1.6 mm and 8.0-11.3 cm in length. All the flaps survived smoothly after surgery and the follow-up period ranged 6-40 (mean 26) months. The texture of the flaps was soft with good function.Conclusion:Free groin flap can be used to repair soft tissue defects in extremities. The main axial vessel is the superficial branch of the superficial circumflex iliac artery, followed by the deep branch or the trunk. The superficial abdominal artery can also be used as an axial vessel. Under the circumstances, the flap design needs to be adjusted without changing the supply area
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AIM: To investigate effect of naringenin on ADP-induced platelet aggregation and its possible mechanism.METHODS: The levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) were measured in the platelets with ADP stimulation using ELISA in the presence or absence of different concentrations of naringenin.The effect of naringenin at different concentrations on the change of phosphodiesterase (PDE) activity was measured by high efficiency liquid chromatography.The effects of naringenin at different concentrations on phosphorylation of vasodilator-stimulated phosphoprotein (VASP) at positions Ser157 and Ser239 in washed platelets with ADP stimulation were analyzed by Western blot.The phosphorylation of VASP at Ser239 was also analyzed in the presence of protein kinase A (PKA), protein kinase G (PKG), or protein kinase C (PKC) inhibitors before incubation with naringenin.The platelet aggregation was measured in the presence of PKA or PKG inhibitors before incubation with naringenin.RESULTS: Naringenin elevated cGMP levels significantly but not cAMP levels in the platelets with ADP stimulation in a dose-dependent manner.Naringenin inhibited PDE activity.Naringenin increased the phosphorylation of VASP at Ser239 in a dose-dependent manner in the platelets with ADP stimulation but only modest changes in the phosphorylation at position Ser157.The phosphorylation level of VASP at Ser239 position was inhibited when the platelets were treated with PKA inhibitor before incubation with naringenin.Incubation of platelets with neither PKG nor PKC inhibitors before treatment with naringenin affect the phosphorylation of VASP at Ser239.Pretreatment with PKA inhibitor but not PKG inhibitor significantly reversed the antiplatelet aggregation by naringenin in ADP-stimulated platelets.CONCLUSION: Naringenin may inhibit platelet activation through the elevation of cGMP-and PKA-mediated VASP phosphorylation.
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AIM: To investigate the antiplatelet aggregation of naringenin and its possible mechanism . METHODS:The effects of naringenin at different concentrations on adenosine diphosphate ( ADP)-induced platelet aggre-gation and platelet spreading on immobilized fibrinogen were detected by aggregational detector and observed under fluores -cence microscope, respectively.The expression of phosphoinositide 3-kinase (PI3K) and the phosphorylation of Akt were analyzed by Western blot .RESULTS:Naringenin significantly inhibited ADP-induced platelet aggregation in a dose-de-pendent manner in vitro and in vivo, and inhibited platelet ' s spreading on immobilized fibrinogen in vitro.Further studies indicated that naringenin inhibited platelet activation accompanied by attenuating not only the activation of PI 3K, but also the phosphorylation of Akt .Moreover, naringenin combined with LY294002 additively inhibited the ADP-induced platelet aggregation.CONCLUSION:Naringenin may inhibit platelet activation by regulation of PI 3K/Akt signaling pathway.
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Objective To systematically assess the clinical efficacy and security of Wendan Decoction in the treatment of dyslipidemia. Methods Retrieved from CNKI, CBM, VIP database, Wanfang Database, and PubMed, articles of RCTs about Wendan Decoction in the treatment of dyslipidemia were included. The searching range was from the establishment of the database to April, 2016. NoteExpress3.2.0 was used to establish database. Two researchers independently screened the articles and extracted the data. Cochrane Systematic Review Manual 5.1.0 was used for quality evaluation. Meta-analysis was performed with RevMan5.3 software. Results 12 articles involving 848 patients were included. Results of Meta-analysis showed that compared with the western medicine treatment, Wendan Decoction group was more capable of significantly improving clinical effective rate of dyslipidemia [OR=2.46, 95%CI (1.41, 4.30), P=0.001], lowering the level of TG [WMD=-0.31, 95%CI (-0.46, -0.15), P=0.0001] and LDL-C [WMD=-0.25, 95%CI (-0.30, -0.20), P=0.00001], but there was no statistical significance in regulating TC [WMD=-0.14, 95%CI (-0.35, -0.08), P=0.49] and HDL-C [WMD=0.04, 95%CI (-0.01, -0.1), P=0.13] between the two groups; compared with the western medicine group, Wendan Decoction combined with western medicine group was more capable in the clinical effective rate of dyslipidemia (P<0.05), regulating the level of TG [WMD=0.30, 95%CI (-0.37, -0.23), P=0.00001], TC [WMD=0.65, 95%CI (-0.80, -0.69), P=0.00001], LDL-C (P<0.05, P<0.01) between the two groups; Wendan Decoction combined with western medicine group had low rate of adverse reactions. Conclusion Wedan Decoction can effectively regulate dyslipidemia, with good safety. High quality RCTs in large-scale and multi-center are necessary for further evidence due to the poor methodological quality of included trials with few samples and other limitations.
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Objective Using STI and WMSI to evaluate the change of the heart sarcomere local systolic function which suffered from coronary heart disease (CHD), to evaluate the improvement of ischemic heart sarcomere local systolic function after PCI. Methods There are 40 CHD patients after PCI called the treatment group and 40 healthy persons called the control group. Echocardiogram was used to evaluate the change of ventricular wall motion score in the treatment group which was before and 1 week after PCI , compared with the control group. STI is used to get the SLs, GSL and SrLe of the left ventricle six walls in basal segment,middle segmentand apical segment systole. Results The ventricular wall motion index of the left ventricular myocardium obviously rose in CHD patients which was after PCI, compared with the control group (P < 0.05). And it obviously reduced in CHD patients after PCI, compared with CHD patients before PCI(P < 0.05). The results of SLs,GSL and SrLe are reduced in myocardial ischemia segment of CHD patients before PCI,compared with the control group (P < 0.05). But they are significantly improved in the the treatment group 1 week after PCI, compared to which is before PCI(P < 0.05). Conclusion STI and WMS can be used to evaluate the abnormal of regional and global function of myocardium which is caused to coronary artery stenosis the effect of PCI. The left ventricular motion function of CHD is decreased, but the left ventricle regional systolic function of hypokinetic segments in patients with CHD after PCI is significantly increased.
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Objective To evaluate the immediate effect and the safety of acupuncture at Taichong(LR 3)on blood pressure of hypertension patients with hyperactivity of liver-yang.Methods Acupuncture treatment was done at Taichong(LR 3)of both sides for the 67 patients with hypertension of 1 or 2 degree,once a day for 7 days.Blood pressure was measured once before and 30 minutes after acupuncture respectively everyday,and the observation was carried out to see whether the patients had adverse reactions.Results Compared the systolic pressure and diastolic pressure after acupuncture with before acupuncture,the difference was significant(P
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To investigate into the effect of ultrasonic - spraying of Chinese Materia medica on respiratory failure, the remedy produced by our hospital was studies for the treatment of 27 cases of such disorder (type II). with another 30 cases treated by coramine as control. Results revealed, for the treatment group, total markedly effective rate was 70. 3%, SaO2 increased to 38. 4%. The rate of amelioration of coughing, dyspnea, sputum and average treating time for the treatment group were all significantly different from the control group (P