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Objective To assess the effects of different statins in the prevention of contrast induced nephropathy (CIN)by comparing the changes of early renal injury biomarker serum levels in patients of with coronary artery angiography (CAG). Methods 183 patients who had normal renal function with CAG with normal renal function were randomly divided into the control group (n=61)、the atorvastatin group (n=60) and the rosuvastatin group (n=62). Renal injury biomarker levels (Scr,mALB, Cys C)and serum inflammatory factor (high sensitivity C reactive Protein,hs-CRP) of three groups were monitored and analyzed before and after CAG. Results The mALB(mg/L, 18.19 ± 8.25 vs. 12.07 ± 6.15,14.81 ± 6.23 vs. 12.32 ± 5.19,15.31 ± 7.53vs. 11.39 ± 5.38), Cys C(mg/L, 1.36 ± 0.32 vs. 0.90 ± 0.38,1.18 ± 0.25 vs. 0.91 ± 0.31,1.15 ± 0.21 vs. 0.93 ± 0.30), hs-CRP(mg/L,5.52 ± 2.09 vs. 1.96 ± 0.55, 3.86 ± 1.15 vs. 2.01 ± 0.34,3.93 ± 1.09 vs. 2.03 ± 0.23)levels in three groups raised up-regulated after angiography with statistical significance (P <0.05). Levels of mALB(mg/L,18.19 ± 8.25 vs. 14.81 ± 6.23, 18.19 ± 8.25 vs. 15.31 ± 7.53), Cys C(mg/L, 1.36 ± 0.32 vs. 1.18 ± 0.25,1.36 ± 0.32 vs. 1.15 ± 0.21), hs-CRP(mg/L, 5.52 ± 2.09 vs. 3.86 ± 1.15, 5.52 ± 2.09 vs. 3.93 ± 1.09)in the statin treatment groups was were lower than that in control group with statistical significance (P < 0.05). But Whereas there was were no significantly difference between the atorvastatin group and the rosuvastatin group [mALB (14.81 ± 6.23) mg/L vs. (15.31 ± 7.53) mg/L, CysC (1.18 ± 0.25) mg/L vs. (1.15 ± 0.21) mg/L,hs-CRP (3.86 ± 1.15) mg/L vs. (3.93 ± 1.09) mg/L,P﹥0.05). Conclusion Satains Statins may prevent this procedure by anti-inflammatory and anti-oxidative-stress mechanism. Different statins with conventional doses may have the same effect of in the prevention of CIN in patients with normal renal function.
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Congenital biliary atresia is considered a neonatal rare disease with multiple causes and phenotypes, whose pathogenesis remains unclear. At present, the etiological study of congenital biliary atresia mainly focuses on viral infection, immune disorder, and dysplasia. This paper summarizes the main etiological hypotheses about congenital biliary atresia nowadays and the connections between them. The research progress provides valuable clues and evidence for the etiology and control of this disease.
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Objective To provide anatomic evidence for the application of the lateral thigh perforator flap.Methods Dissected five fresh Chinese adult lower limbs specimens which were injected with red latex via arterial cannula.On the lateral area of middle and distal thigh,obseved the number,distribution,course,category,length of pedicle and external diameter of the flaps' perforators on specimens.Results On the lateral area of middle and distal thigh 19 perforator arteris were observed in these specimens,averagely there were (3.8 ± 1.3) cutaneous perforators in each flap.Perforators mainly origined from the third perforator artery of profunda femoris,secondly from the second,fourth perforator artery and superior lateral genicular artery.Cutaneous perforators of the third perforator artery of profunda femoris pierced the flap on (13.8 ± 1.5) cm proximal of the fibulae capitulum,while the cutaneous perforators of superior lateral genicular artery on (8.6 ± 1.3) cm proximal of the fibulae capitulum.Averagely internal diameter of cutaneous perforators was (0.7 ± 0.2) mm at the point where the perforators pierced deep fascia.The diameter of the profunda femoris was (1.9 ± 0.2) mm,and the pedicle length was (12.2 ± 0.6)cm.The diameter of superior lateral genicular artery was (1.5 ± 0.2)mm,and the pedicle length was (6.8 ± 1.1) cm.There were inosculated branch in these perforators which came from profunda femoris and superior lateral genicular artery.Conclusion The anatomic characteristic allowed this flap would likely be clinically useful in repairing soft tissue defects in extremity limbs as a free or pedicled flap,which the cutaneous perforators invariably appeared on the skin of lateral areat of middle and distal thigh ; the flap could obtain enough length of the pedicle from its origination ; the vessel has large caliber supporting a substantial cutaneous territory.
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ObjectiveTo probe the feasibility and therapeutic effect of the lateral thigh perforator flap for repairing soft tissue defects in extremity limbs.MethodsDissected six fresh Chinese adult lower limbs specimens which were injected with red latex via arterial cannula. Obseved the number, distribution,course, category of the flaps'perforators and measured their length of pedicle, external diameter on the specimens.Combinafing the results of the anatomy study,thirteen lateral thigh perforator flaps,whose size were 3.0 cm × 3.0 cm - 19.0 cm× 8.0 cm, were applyied to repair different defect, in which 1 was pedieled flap and 12 were free flaps.Two of them applied vessel anastomosis in series with anterlateral thigh perforator flap. The axis was from the fibulae capitulum to greater trochanter of femur.ResultsAll 13 flaps surived com-pletely.In 3-6 months follow-up,all flaps were with thin and good appearance,and they were characterized by soft texture and good colour.No chimatlon and ulcer appeared in any flap.There were no effect of motor function in donor site because of muscle conglutination and scar contracture. There were plainness figure in donor site where skin- grafing was used, and only linearity scar remained where sewed directly.ConclusionThe lateral thigh flap had provided with thin and pleasing appearance, soft texture and minor morbidity in donor site and correspondingly easy dissection. It was feasiblely to repair middling to little skin and soft tissue defect in extremity limbs as a free flap, and to repair skin and soft tissue defect in knee and popliteal space as a pedicel flap.It could apply vessel anastomosis in series with anterlateral thigh perforator flap for repairing large defect.
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Objective To present the therapeutic effect of the free bilobed posterior interosseous flap for soft tissue reconstruction of two fingers.Methods According to the distance between the defects of two adjacent fingers,combining the cutaneous branches of different regin,the free bilobed flaps pedicded with posterior interosseous artery were applied for soft tissue reconstruction of 20 fingers in 10 patients.The defects of digits was on thumb and index( 1 case),index and middle(2 cases),middle and ring(4 cases),ring and little (3 cases).The size of defect was ranged from 2.5 cm × 2.0 cm to 9.5 cm × 3.0 cm.The size of single flap was from 3.0 cm × 2.5 cm to 10.0 cm × 3.5 cm.Results The flaps on 19 fingers were completely survived and the flap on 1 finger had the pointed end necrosis which healed by dressing changing.After 6 to 22 months (the average was 13.8 months ) followed-up visit,all flaps were with excellent colour and texture.The flaps in 8 cases were thin and the flap in 2 case was a little thick.Eight single flaps in which the cutaneous nerve was sutured recovered 2-PD of 10 to 15 mm (the average was 12.8 mm).There was no affection in motor function on donor site of all cases.Conclusion The free bilobed posterior interosseous flap is the valuable option for two fingers soft tissue reconstruction and it can achieve the cosmetically and fuctionaly acceptable result with low morbidity on donor site.
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Objective To explore the method of sensory reconstruction after the operation of reversed island pedicled sural flap and evaluate its therapeutic effect of clinical application. Methods Thirteen clinical cases with traumatic soft tissue defects in heel had recepted the treatment of reversed island pedicled sural flap. All flaps were innervated by anastomosing the distal end of the sural nerve in the flaps and the recipient nerve (superficial peroneal nerve) in end to end or end to side. All patients were evaluated at 9-15 months on the postoperative follow-up parameters, including flap contour, flap stability, locomotor activity,touch sensation, pain sensation, static two-point discrimination, thermal sensibility, and the skin sensory recovery level in lateral dorsutn of foot. Results Thirteen cases flaps had good blood supply and primary healing. All cases were followed up 9-15 months, the rate of good sensory recovery was 53.85%. All pa tients had protective sensory in lateral dorsum of foot, the rate of good sensory recovery was 61.54%. Conclusion Anastomosing the proximal end of sural nerve and superficial peroneal nerve together will be good for the sensory recovery in flap and lateral foot in repairing soft tissue defects in heel with reversed island pedicled sural flap.