The Construction of Doctor-patient Community with a Shared Future Based on Mencius’ Theory of Original Goodness of Human Nature / 中国医学伦理学

Since the first medical reform, China has carried out three reforms and improvements to the medical system. However, there are still some shortcomings, the problems at different levels are mainly reflected in the doctor-patient relationship. Doctor-patient conflict has become one of the hot topics of social focus. Under the development of the country and the joint efforts of all parties, doctor-patient conflict has been alleviated to a certain extent, and the doctor-patient relationship has been developing in a better direction. With the proposal of the concept of "doctor-patient community with a shared future", the joint construction of a community between doctors and patients has become a further goal. Mencius’ theory of original goodness of human nature echoes the construction of the contemporary doctor-patient community with a shared future. It criticizes the empirical theory of human nature and emphasizes the constructive and initiative of goodness in nature, that is, to achieve goodness in nature through preservation and expansion. In the doctor-patient relationship, goodness in nature is the construction of doctor-patient community with a shared future, which requires both doctors and patients to work together with firm confidence and gradually complete the construction of the community by continuous practice.

Inhibitory effect of GALNT2 gene knockdown on apoptosis of human retinal vascular endothelial cells in high glucose culture and its mechanism / 中华实验眼科杂志

Objective:To investigate the effect of polypeptide N-acetylgalactosaminaminyltransferase 2 (GALNT2) on the proliferation and apoptosis of human retinal vascular endothelial cells (HRCECs) cultured in high glucose and its possible mechanism.Methods:The small hairpin RNA (shRNA) targeting GALNT2 gene was constructed to interfere with the lentiviral vector and infect HRCECs.HRCECs were divided into blank control group, model group, NC-shGALNT2 group and shGALNT2 group, which were cultured in medium containing 5.5 mmol/L glucose, 25 mmol/L glucose, shGALNT2 negative control virus 25 mmol/L glucose and shGALNT2 knockdown virus 25 mmol/L glucose for 24 hours, respectively.The relative expression of GALNT2 mRNA in the four groups was detected by real-time fluorescence quantitative PCR.The relative expression levels of GALNT2, epidermal growth factor (EGF), EGF receptor (EGFR) and phosphorylated EGFR (p-EGFR) were detected by Western blot.The proliferative values of HRCECs were detected by cell counting kit-8 method.The apoptosis rate of different groups was detected by flow cytometry. Results:The relative expression levels of GALNT2 mRNA and protein were significantly higher in model group than in blank control group, and were significantly lower in shGALNT2 group than in blank control group (all at P<0.05). The cell proliferation value was significantly lower in model group than in blank control group, and was significantly higher in shGALNT2 than in model group and NC-shGALNT2 group (all at P<0.05). The apoptosis rates of blank control group, model group, NC-shGALNT2 group and shGALNT2 group were (4.73±0.26)%, (8.66±0.25)%, (9.26±1.12)% and (5.47±0.18)%, respectively, with a significant overall difference ( F=342.921, P<0.001). The apoptosis rate was significantly higher in model group than in blank control group, and was significantly lower in shGALNT2 group than in model group and NC-shGALNT2 group (all at P<0.05). The relative expression level of EGFR protein was significantly higher and the relative expression level of p-EGFR protein was significantly lower in model group than in blank control group (all at P<0.05). The relative expression of p-EGFR protein was significantly higher in shGALNT2 group than in model group (all at P<0.05). Conclusions:Knocking down GALNT2 can improve the proliferative ability of HRCECs under high glucose culture and reduce apoptosis, which may be related to the activation of EGFR signaling pathway.

Impact of dispatcher-assisted cardiopulmonary resuscitation on survival after out-of-hospital cardiac arrest: A Meta-analysis / 中华急诊医学杂志

Objective:To evaluate the outcome of the patients receiving dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) delivered by first-responders who witnessed the out-of-hospital cardiac arrest (OHCA) before the Emergency Medical Service (EMS) arrived.Methods:We performed a search of the relevant literature exploring major scientific databases. We assessed the quality of the included cohort study according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Meta-analysis was performed on three outcome indicators (recovery of spontaneous circulation survival to hospital discharge and survival with favourable neurologic outcome) using the Revman5.3 software.Results:A total of 21 studies with 349 822 patients were selected for the meta-analysis, including 182 125 patients in the DA-CPR group and 167 697 in the CPR-only group. The meta-analysis showed no significant difference between the DA-CPR and CPR-only groups in ROSC [ RR=1.10, 95% confidence interval ( CI): 0.94-1.29, P=0.24], survival to hospital discharge ( RR=1.10, 95% CI: 0.90-1.34, P=0.34) and survival with favourable neurologic outcome ( RR=1.01, 95% CI: 0.79-1.28, P=0.97) of the patients in America, Japan and Korea. However, there was a significant difference between the DA-CPR and the CPR-only groups in ROSC ( RR=2.61, 95% CI:1.53-4.46, P=0.0005), survival to hospital discharge( RR=6.08, 95% CI: 1.84-20.04, P=0.003), and survival with favourable neurologic outcome( RR=9.76, 95% CI: 1.87-51.02, P=0.007) of the patients in China. Conclusions:The overall effect of DA-CPR is significantly different for each country. In detail, DA-CPR offers a survival advantage (Return of spontaneous circulation, survival to hospital discharge and survival with favourable neurologic outcome) over CPR alone in China but no advantage in developed countries.

Analysis of interactions of immune checkpoint inhibitors with antibiotics in cancer therapy / 医学前沿

The discovery of immune checkpoint inhibitors, such as PD-1/PD-L1 and CTLA-4, has played an important role in the development of cancer immunotherapy. However, immune-related adverse events often occur because of the enhanced immune response enabled by these agents. Antibiotics are widely applied in clinical treatment, and they are inevitably used in combination with immune checkpoint inhibitors. Clinical practice has revealed that antibiotics can weaken the therapeutic response to immune checkpoint inhibitors. Studies have shown that the gut microbiota is essential for the interaction between immune checkpoint inhibitors and antibiotics, although the exact mechanisms remain unclear. This review focuses on the interactions between immune checkpoint inhibitors and antibiotics, with an in-depth discussion about the mechanisms and therapeutic potential of modulating gut microbiota, as well as other new combination strategies.

Research progress of neurofilament light chain in the parkinsonism / 中华神经科杂志

Neurofilament light chain (NfL), a sensitive biomarker of axonal damage, was found increasing in several neurological diseases. Parkinsonism is a group of clinical syndromes characterized by cardinal symptoms of bradykinesia, rigidity, and tremor, including Parkinson′s disease (PD) and parkinsonism plus syndrome (PPS). It is difficult in the diagnosis and differential diagnosis of PD and PPS, especially in the early stage. Evidence suggests that NfL in the cerebrospinal fluid and blood is a promising biomarker for the differential diagnosis of PD and PPS. This article reviewed and summarized the research progress of value of NfL in PD and PPS, and proposed future research directions.

The effect of mechanical chest compression device on resuscitation in patients with cardiac arrest: A meta-analysis / 中华急诊医学杂志

Objective:To evaluate the effect of mechanical chest compression device in patients with cardiac arrest.Methods:The relevant literatures about mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation were systematically searched from China Knowledge Network (CNKI), VIP, Wanfang, PubMed, Web of Science and other databases. The effective data were extracted and analyzed by RevMan5.3 software.Results:A total of 20 clinical studies involving 29 727 patients were included, of which 11 104 patients received mechanical cardiopulmonary resuscitation and 18 623 patients received traditional manual cardiopulmonary resuscitation. The results of meta-analysis showed that mechanical cardiopulmonary resuscitation could not effectively improve the restoration of spontaneous circulation (ROSC) rate, admission survival rate, discharge survival rate and neurological prognosis in patients with cardiac arrest compared with manual cardiopulmonary resuscitation. ROSC occurrence rate ( RR=1.10, 95% CI: 0.99-1.23, P<0.01), admission survival rate ( RR=1.01, 95% CI: 0.95-1.08, P=0.67), discharge survival rate ( RR=1.00, 95% CI: 0.86-1.15, P=0.14), and good neurological function rate ( RR=0.81, 95% CI: 0.61-1.06, P=0.69) showed no significant differences between the mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation. Conclusions:Mechanical chest compression device has no advantage compared with manual cardiopulmonary resuscitation. Mechanical cardiopulmonary resuscitation is not recommended to completely replace manual chest compression in cardiopulmonary resuscitation.

Clinical study on treatment of senile severe pneumonia by Qingre-Tongfu enema combined with non-invasive ventilation with syndrome of excess of Yangming fushi / 国际中医中药杂志

Objective:To investigate the effect of Qingre-Tongfu enema combined with noninvasive positive pressure ventilation on the ventilation function of elderly patients with severe pneumonia. Methods:A total of 60 elderly patients with severe pneumonia with syndrome of excess of Yangming fushi from September 2017 to August 2019 in the respiratory department of the First People’s Hospital of Dongcheng District, Beijing were randomly divided into two groups, 30 cases in each group. The control group was treated with western medicine to control infection and noninvasive positive pressure ventilation. The treatment group was treated with Qingre-Tongfu enema on the basis of the control group. The Traditional Chinese Medicine Syndrome score (TCMSSS), Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE-Ⅱ) and Clinical Pulmonary Infection Score (CPIS) were compared before and after treatment, The Pneumonia Severity Index (PSI) was compared. Serum procalcitonin (PCT) was detected by upconversion luminescence immunoassay, CRP was detected by double antibody sandwich ELISA, WBC was detected by automatic hematology analyzer; partial pressure of carbon dioxide (PaCO 2), oxygen saturation (SaO 2), partial pressure of oxygen (PaO 2) were detected by blood gas analyzer, oxygenation index (OI) and respiratory rate (RR) were calculated. The complications were investigated and the clinical efficacy was evaluated. Results:The total effective rate was 96.7% (29/30) in the treatment group and 73.3% (22/30) in the control group, with significant difference between the two groups ( χ2=4.706, P=0.030). After treatment, the levels of serum PCT, CRP and WBC in the treatment group were significantly lower than those in the control group ( t=15.359, 25.784 and 13.460, respectively, P<0.01); after treatment, the levels of SaO 2 [(93.18 ± 3.79)% vs. (88.78 ± 5.56)%, t=3.584], PaO 2 [(86.81 ± 4.01) mmHg vs. (80.01 ± 4.76) mmHg, t=5.975], OI [(285.53 ± 15.05) mmHg vs. (227.65 ± 12.37) mmHg, t=16.272] in the treatment group significantly were higher than those in the control group ( P<0.01); PaCO 2 [(43.28 ± 6.84) mmHg vs. (48.83 ± 7.66) mmHg, t=-2.956], RR [(22.00 ± 3.79) times/min vs. (26.30 ± 3.73) times/min, t=-4.434] in the treatment group were significantly lower than those in the control group ( P<0.05). After treatment, the scores of TCMSSS, APACHE-Ⅱ, CPIS and PSI in the treatment group were significantly lower than those in the control group ( t=41.310, 11.035, 8.399, 5.752, P<0.01). The treatment group in the course of antibiotics, mechanical ventilation time, hospital stay were significantly shorter than the control group ( P<0.01). Conclusion:Qingre-Tongfu enema combined with noninvasive positive pressure ventilation can improve the clinical symptoms of elderly patients with severe pneumonia, reduce inflammatory reaction, shorten the time of mechanical ventilation and antibiotic treatment, and improve the clinical efficacy.

Advances in biodegradation of macrolide antibiotics / 生物工程学报

Macrolide antibiotics are a class of broad-spectrum antibiotics with the macrolide as core nucleus. Recently, antibiotic pollution has become an important environmental problem due to the irregular production and abuse of macrolide antibiotics. Microbial degradation is one of the most effective methods to deal with antibiotic pollution. This review summarizes the current status of environmental pollution caused by macrolide antibiotics, the degradation strains, the degradation enzymes, the degradation pathways and the microbial processes for degrading macrolide antibiotics. Moreover, the critical challenges on the biodegradation of macrolide antibiotics were also discussed.

Combined application of DOPS and Mini-CEX in clinical skill evaluation / 中华医学教育探索杂志

Clinical skills training is an important part of medical students' training, which requires the selection of appropriate evaluation tools. At present, the direct observation of procedural skills (DOPS) and mini clinical evaluation exercise (Mini-CEX) are widely used, however, it is not comprehensive to use only one of the tools for evaluation. Based on the application situation of DOPS and Mini-CEX in clinical skill assessment at home and abroad, this paper will elaborate the combined application of DOPS and Mini-CEX in clinical teaching and standardized residency training for resident physicians, so as to make more comprehensive and systematic evaluation.

Effects of the Mineral Oil Covered M2 Droplet Culture, M16 Droplet Culture, and DMSO on Release of Mouse Oocytes from Diplotene Arrest / 中国医科大学学报

Objective To study the effects of mineral oil covered M2 culture medium droplet culture, M16 droplet culture, and dimethyl sulfoxide (DMSO) on the morphology and survival rates of mouse oocytes during the release from diplotene arrest. Methods Oocytes were randomly divided into 3 groups and individually cultured for 4 h in M2 covered with mineral oil, M16 covered with mineral oil, and/or M16 only to cause germinal vesicle breakdown (GVBD). The morphological changes and survival rates of oocytes in each group were observed under the microscope. Oocytes were randomly divided into 3 groups and cultured in the medium with 0％, 1％, and 2％ DMSO. The effect of DMSO on oocytes was also observed during the release from diplotene arrest. Results The survival rates of oocytes in M2 covered with mineral oil were higher than those in M16 (P ＜ 0.05). There was no statistical difference with respect to release of mouse oocytes from diplotene arrest between the oocytes in M2 covered with mineral oil and oocytes in M16. The shape of oocytes in M2 with mineral oil was better than that of oocytes in M16. The effect of DMSO on the survival rate of oocytes was similar in the medium with 0％, 1％ and 2％DMSO. But the effect of 2％ DMSO on the release of oocytes was statistically significant (P ＜ 0.01). Conclusion During the release of mouse oocytes from diplotene arrest, oocytes in M2 covered with mineral oil have much better morphology and higher survival rate than those in M16. DMSO (0％, 1％ and 2％) has no effect on the survival rate of oocytes. However, 2％ DMSO is more effective in promoting the release of mouse oocytes from diplotene arrest.

Effects of Illness Perception and Health Beliefs on the Quality of Life of Breast Cancer Patients in the Yanbian Area of China

PURPOSE: This study aimed to identify the effects of illness perception and health beliefs on the quality of life (QOL) of breast cancer patients. METHODS: A cross-sectional study was conducted. Data were collected using questionnaires administered to 200 patients admitted for chemotherapy after a partial or total mastectomy at a university hospital in Yanji City. The data were analyzed using t-tests, analysis of variance, Pearson's correlation coefficients, and hierarchical regression analysis. RESULTS: The QOL of the breast cancer patients was significantly correlated with health beliefs and a subfactor of illness perception. The significant factors influencing QOL were understanding illness and feeling threatened, accounting for 31.7% of the variance in QOL. CONCLUSION: Illness perception of breast cancer patients had a negative influence on QOL, whereas health beliefs affected it positively. An implication of this study's findings is that interventions to reduce negative illness perception can improve the QOL among breast cancer patients.

Treatment of pretibial myxedema with local subcutaneous injection of glucocorticoid:Three cases report / 中华内分泌代谢杂志

To investigate the treatment of hyperthyroidism complicated with pretibial myxedema. Three patients with hyperthyroidism complicated with pretibial myxedema were treated with topical injection of corticosteroid at the skin lesion. All 3 patients were cured with pretibial mucous edema by local injection of corticosteroids. Multi-point injection of glucocorticoid combined with maintaining euthyroid state is effective and has little side effect.[Summary] To investigate the treatment of hyperthyroidism complicated with pretibial myxedema. Three patients with hyperthyroidism complicated with pretibial myxedema were treated with topical injection of corticosteroid at the skin lesion. All 3 patients were cured with pretibial mucous edema by local injection of corticosteroids. Multi-point injection of glucocorticoid combined with maintaining euthyroid state is effective and has little side effect.

Self-health management ability of college students of Zhuang nationality in underdeveloped areas and assoliated factors / 中国学校卫生

Objective@#To understand the self-health management ability of college students of Zhuang nationality in the economically underdeveloped areas of Guangxi and assoliated factors, and to provide support for improving the health of college students in economically underdeveloped areas.@*Methods@#Five colleges and universities were selected in the economically underdeveloped areas of Guangxi, and 1 042 college students of Zhuang nationality were randomly selected to conduct self-health management ability surveys, and the influencing factors affecting self-health management ability were analyzed.@*Results@#The self-health management ability of Zhuang college students in the economically underdeveloped areas of Guangxi scored (3.63±0.59) points. The scores of boys’ self-health management behaviors were higher than those of girls, which was statistically significant (t=2.92, P<0.01). There was a statistically significant difference in the total scores of cognitive and self-health management among students of different grades (F=8.03, 3.04, P<0.01). The dimensions and total scores of self-health management of medical students were higher than those of other majors, and there was statistical significance (P<0.01). The scores of behavior, environment and total scores of students with different self-assessment status were statistically significant (P<0.01). Regression analysis showed that professional, gender, and self-rated health were the main influencing factors of behavior and environment (P<0.01); gender, grade, and major were the main influencing factors of cognition (P<0.01); grade, professional, self-evaluation health were the main influencing factors of the total score of self-health management (P<0.01).@*Conclusion@#The Zhuang nationality students in the economically underdeveloped areas of Guangxi have higher self-health management ability, but their behaviors are not very good. They should be intervened and guided by different groups to improve the self-health management ability of Zhuang college students.

Treatment of pretibial myxedema with local subcutaneous injection of glucocorticoid: Three cases report / 中华内分泌代谢杂志

To investigate the treatment of hyperthyroidism complicated with pretibial myxedema. Three patients with hyperthyroidism complicated with pretibial myxedema were treated with topical injection of corticosteroid at the skin lesion. All 3 patients were cured with pretibial mucous edema by local injection of corticosteroids. Multi-point injection of glucocorticoid combined with maintaining euthyroid state is effective and has little side effect.

Nonclinical safety evaluation of Insulin NPH, a biosimilar of Humulin NPH / 药物评价研究

Objective To investigate the toxic reaction,toxic organs or target tissues of protamine recombinant human insulin (Insulin NPH),and provide basis for clinical trials by single dose toxicity test in mice,repeated toxicity and immunogenicity of Beagle's dogs,and systemic active allergy in guinea pig.Methods ① Using maximum dose method,mice in single dose toxicity test were sc injected with normal saline (NS),vehicle,and Insulin NPH (2092-2488 IU/kg),the toxic reactions after injection were monitored.② In repeated toxicity study,Beagle's dogs were sc administrated with vehicle,the original (Humulin NPH,1.5 IU/kg)and different doses of Insulin NPH (0.5,1.0 and 1.5 IU/kg) for 30 d continuously,followed by a 14-d recovery.During the administration and recovery period,general observation,local irritation,body weight,anus temperature,blood glucose,and electrocardiogram (ECG) were checked,moreover,hematology,serum biochemistry and urine were detected.Also,organic weights and histopathological examination were conducted.Binding antibodies in dog serum were measured by indirect ELISA method in immunogenicity test.③ In systemic active allergy study,cavies were sc injected with low-and high-dose (4 and 12 IU/kg) Insulin NPH,normal saline and vehicle.Besides,ova as positive control was also included.After five times of sensitization test with above doses,the excitation reactions of iv injection with tripled sensitizing doses were observed.Results No obvious toxicity was observed in mice after injected with 165 times of usual clinical dose of Insulin NPH.Repeated toxicity study of Beagle's dogs revealed that 1.0 IU/kg was the no-toxic-effect dose (NOAEL) for Insulin NPH,which was equivalent to 2 times of clinical dose.No bindingantibodies were found in immunogenicity test.There was no obvious allergic symptom in the active systemic allergy study of guinea pig.Conclusion Under the experimental conditions,no serious toxicity of Insulin NPH is found.

Effects of oridonin on invasion and migration of human hepatocellular carcinoma MHCC-97H cells / 中国病理生理杂志

AIM: To investigate the effects of oridonin on the invasion and migration of hepatocelluar carcinoma cells.METHODS: Human hepatocelluar carcinoma MHCC-97H cells were cultured and treated with 5, 10 or 20 μmol/L oridonin.The migration ability was measured by wound healing assay.The invasion ability was examined by Transwell invasion assay.The adhesion capabilities were evaluated by adhesion assay.The protein levels of LIM kinase-1 (LIMK-1), cofilin and phosphorylated cofilin (p-cofilin) were determined by Western blot.RESULTS: Oridonin inhibited the migration, invasion and adhesion abilities of MHCC-97H cells in a dose-dependent manner (P<0.05).After oridonin treatment, the expression of cofilin had no obvious change, but the protein levels of LIMK-1 and p-cofilin decreased significantly.CONCLUSION: Oridonin inhibits the invasion and migration of MHCC-97H cells.The mechanism may be related with the regulatory effect of oridonin on LIMK-1/cofilin signal transduction pathway.

STAT3 Activation Way Blocking Effects on Colorectal Cancer cells HT29 Growth / 中国现代普通外科进展

Objective:Explore decoy oligonucleotide (ODN) technology targeted blocking STAT3 activation way effects on colorectal cancer HT29 cell growth,to provide experimemt basis for gene therapy of colorectal cancer.Methods:Using decoy ODN in vitro transfect colorectal cancer HT29 cell line,to targeted blocking STAT3 activation way.Fluorescence microscope and flow cytometry detect transfection conditions and efficiency,and MTT method detect the cell growth inhibition,Realtime RT-PCR and Western blotting test STAT3 in cells,the Bcl-xl and Caspase3 mRNA and protein expression.Results:STAT3 decoy ODN can efficient transfection into colorectal cancer cells,and is due to the nucleus.HT29 cell in the STAT3 decoy ODN,growth inhibition rate increased significantly,and mRNA and quantity of protein expression of STAT3 significantly reduce (P＜0.05),while caspase3 increase significantly (P＜0.05).Conclusion:Named Decoy ODN targeted after blocking STAT3 activation way,which can effectively cut colorectal cancer cells HT29 STAT3 gene expression,and inhibit the growth of the cells.The mechanism may be related to lower the expression of STAT3 and the Bcl-xl and Caspase3.

Influence of metal ions on stability of 2,3,5,4'-tetrahydroxy stilbene-2-O-β-D-glucoside contained in Polygoni Multiflori Radix / 药学学报

Decoction is one of the most commonly used dosage forms of traditional Chinese medicine. The stability of chemical constituents in decoction is closely related to the clinical efficacy and safety. There were few reports about the influence of metal ions in the stability of chemical constituents in traditional Chinese medicine. However, there is no evidence that metal ions in decoction water need to be controlled. In this study, 2,3,5,4'-tetrahydroxy stilbene-2-O-β-D-glucoside (THSG), one of the main constituents in Polygoni Multiflori Radix was studied. Ordinary tap water, deionized water, and water containing different metal ions were used to investigate and compare the influence on THSG. The results showed that after storage in a dark place at the room temperature for 10 days, the degradation of THSG was 7% in deionized water, while undetectable in tap water. The content of THSG could be decreased by different kinds of metal ions, and the effect was concentration-dependent. Moreover, Fe3+ and Fe2+ showed the greatest influence at the same concentration; and our study has shown that THSG decreased more than 98% in Fe and Fe2+ solutions at 500 ppm concentration. In the same time we found out p-hydroxybenzaldehyde (molecular weight: 122.036 7) and 2,3,5-trihydroxybenzaldehyde-2-O-glycoside (molecular weight: 316.079 4) were the main degradation products of THSG in tap water and water containing Cu2+, Ca2+, Zn2+, Mg2+ and Al3+. The product of THSG dimer with a water molecule was found in water containing Fe3+ and Fe2+. The above results showed that the metal ions in water could significantly influence the stability of THSG in water, indicating that the clinical efficacy and safety of decoction would be affected if the metal ions in water were not under control. It's suggested that deionized water should be used in the preparation of decoction containing Polygoni Multiflori Radix in the clinic to avoid degradation of THSG. Meanwhile, decoction prepared by tap water should be taken by patients in a short time. Our investigation provides important information and reference about the influence of metal ions on the stability of decoctions in other traditional Chinese medicine that have unstable groups such as hydroxyls and unsaturated bonds, etc.

Analysis of clinic effect of the free arm lateral neurocutaneous flap in repairing cutaneous defects of opisthenar: 12 cases report / 中华显微外科杂志

Objective To explore clinic effect and advantages of the free arm lateral neurocutaneous flap in repairing cutaneous defects of opisthenar.Methods Between July,2012 and December,2013,12 patients with skin and soft tissue defects in opisthenar caused by trauma factor,accident,machine injury,hot crush injury etc were treated with free arm lateral neurocutaneous flap at our institution.Vessels both in recipient and donor site were detect-ed by color Doppler ultrasound preoperatively.Relative cutaneous nervers were reserved in the flap during selective operation.The flap size resected range from 6 cm × 4 cm to 10 cm × 6 cm.The posterior cutaneous nerve of the forearm were included in the flap to restore sensory sesation after transection.The wound in the donor site was closed in in-tradermal suture primarily.Postoperative algesia,touch,temperature sensation,Weber test of flap were tested and reco-rded.The critia of follow-up in this study were donor site morbidity,abnormal sensations,functional outcomes and sat-isfaction.Results The success rate was 100 percent in the series cases.The average length of follow up was 35 months (range,24 to 41 months).The wound in recipient area healed primarily and flaps showed no pigmentation but fine overall appearance,texture,and elasticity.The functional recovery of protective sensation was S3+ in 4 cases,S3 in 6,S2 in 2.Patients with liner scar in donor site were higly satisfied with the flaps for the sake of no significant joint functional outcomes.In terms of sensory sesation,the excellent and good rate of flap reached to 83 percent.Conclusion The free arm lateral flap represented a constant vascular anatomy,rich blood supply.Easy dissection,pliable texture,skin colour close to dorsum of hand and the possibility to be innervated through the posterior cutaneous nerve of the arm acceptable donor side morbidity provide a good option for the reconstruction of cutaneous defects of opisthena.

Influence of Different Decoction Conditions on Chemical Components in Fufang Baidu Decoctions / 中国药师

Objective:To investigate the influence of different decoction containers on the chemical components in Fufang Baidu decoctions to provide scientific evidence for the establishment of rational decoction method for traditional Chinese medicine decoctions. Methods:The method of UPLC was adopted to study the influence of different decoction containers on the content of astilbin, forsytho-side A and forsythoside in Fufang Baidu decoctions. Results:With the different containers, the content change regularity was as fol-lows:porcelain pot >stainless steel pot> decocting machine of Chinese herbs> earthen pot> glass pot. Conclusion:Decocting ma-chine for Chinese herbs can be an substitute for traditional boiling utensils.