Drug resistance and pathogenic spectrum of patients coinfected with nontuberculous mycobacteria and human-immunodeficiency virus in Chengdu, China / 中华医学杂志(英文版)

Background@#Human-immunodeficiency virus (HIV) infection is increasing worldwide and nontuberculous mycobacteria (NTM) is an established microbiologic cause of pulmonary disease, lymphadenitis, and disseminated disease in cases of advanced immune suppression. Data on patients coinfected with HIV and NTM are limited. Thus, this study aimed to analyze the clinical characteristics, drug resistance, and pathogen spectrum of patients coinfected with both HIV and NTM in the Chengdu area of China.@*Methods@#Data of 59 patients coinfected with both HIV and NTM collected from the Public Health Clinical Center of Chengdu, between January 2014 and December 2018, were analyzed. NTM drug sensitivity testing was performed using the microporous plate ratio method. Data were analyzed using SPSS 19.0, and the change in drug resistance rate was analyzed using the chi-square (χ2) test.@*Results@#Seven species/complex of NTM were identified from patients coinfected with HIV and NTM in this study, with Mycobacterium avium–intracellulare complex (52.5%) and M. kansasii (27.1%) as the predominant species. Male patients were more affected 50/59 (84.7%); the mean age of the 59 cases was 45 years. The clinical characteristics mainly included anemia (86.4%), cough and expectoration (79.7%). The baseline CD4 count was <50 cells/μL (84.7%). Patients were mainly in advanced acquired immunodeficiency syndrome (AIDS) stage. Chest imaging mainly showed patchy shadows (42.4%) and nodules (32.2%), with various degrees of AIDS-defining diseases. The drug resistance of NTM was severe, and the rate of isoniazid resistance (100.0%) was the highest, followed by rifampicin (94.9%), streptomycin (94.9%), ofloxacin (93.2%), and others. Ethambutol (52.5%) and clarithromycin (33.9%) were relatively low. No significant difference was found in the drug resistance rate of NTM strain against nine antituberculosis drugs in 5 years (P > 0.05).@*Conclusions@#The immune level of patients coinfected with HIV and NTM is low in advanced AIDS stage; more male are affected in patients who are mainly infected with MAC and M. kansasii and with serious drug resistance. The drug resistance rate of ethambutol and clarithromycin is relatively low.

Drug resistance and pathogenic spectrum of patients coinfected with nontuberculous mycobacteria and human-immunodeficiency virus in Chengdu, China / 中华医学杂志(英文版)

BACKGROUND@#Human-immunodeficiency virus (HIV) infection is increasing worldwide and nontuberculous mycobacteria (NTM) is an established microbiologic cause of pulmonary disease, lymphadenitis, and disseminated disease in cases of advanced immune suppression. Data on patients coinfected with HIV and NTM are limited. Thus, this study aimed to analyze the clinical characteristics, drug resistance, and pathogen spectrum of patients coinfected with both HIV and NTM in the Chengdu area of China.@*METHODS@#Data of 59 patients coinfected with both HIV and NTM collected from the Public Health Clinical Center of Chengdu, between January 2014 and December 2018, were analyzed. NTM drug sensitivity testing was performed using the microporous plate ratio method. Data were analyzed using SPSS 19.0, and the change in drug resistance rate was analyzed using the chi-square (χ) test.@*RESULTS@#Seven species/complex of NTM were identified from patients coinfected with HIV and NTM in this study, with Mycobacterium avium-intracellulare complex (52.5%) and M. kansasii (27.1%) as the predominant species. Male patients were more affected 50/59 (84.7%); the mean age of the 59 cases was 45 years. The clinical characteristics mainly included anemia (86.4%), cough and expectoration (79.7%). The baseline CD4 count was 0.05).@*CONCLUSIONS@#The immune level of patients coinfected with HIV and NTM is low in advanced AIDS stage; more male are affected in patients who are mainly infected with MAC and M. kansasii and with serious drug resistance. The drug resistance rate of ethambutol and clarithromycin is relatively low.

Biomechanical and histological research on in vivo engineered tendon with tendon synovial sheaths in Roman chicken / 医用生物力学

Objective To explore the role of tendon synovial sheaths in tendon regeneration in vivo. Methods Thirty-six Roman chicken were randomly divided into Group A and B, with 18 chicken in each group. In Group A, the synovial sheaths of the deep flexor tendons in the left middle toes were separated from the up, right and down side without cutting off the tendons themselves. The allograft decellularized tendons were coated with synovial sheaths which were detached partly and fixed on the left side of the normal deep flexor tendons in the middle toes of the left foot. In Group B, the allograft decellularized tendons were directly implanted on the left side of the deep flexor tendons without coating of synovial sheaths. The normal deep flexor tendons from the right foot were used as the control group. The maximum loads and elastic modulus of the tendons at 4th, 8th and 12th week were obtained by mechanical testing, and HE staining was conducted to observe histological changes of the tendons. Results The maximum load at 8th and 12th week and elastic modulus at 4th, 8th and 12th week in Groups A were greater than those in Group B, with significant differences (P<0.05). Group A showed more densely deposited matrices and longitudinally aligned collagen fibers than Group B, and inflammatory cells and fibrous tissues could hardly be found in Group A. In Group B, the collagen fibers were decreased gradually, with disordered alignment. Furthermore, more inflammatory cells infiltration and hyperplasia of fibrous tissues were found in Group B. Conclusions The synovial sheaths can contribute to tendon regeneration, indicating that a proper environment in vivo plays an important role in the engineered tendons. This study has a positive effect on finding proper tendon replacements for patients with tendon deficiency.

The significance of ultrasound and mammography in the diagnosis of fat necrosis after fat transplantation in breasts / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the significance and images characters of ultrasound and mammography in the diagnosis of fat necrosis after fat transplantation in breasts(FTB).</p><p><b>METHODS</b>From June 2005 to June 2012, 13 cases with 96 fat necrosis lumps after FTB, were retrospectively reviewed. The pre-operative images of ultrasound and mammography, as well as the post-operative histologic results were collected.</p><p><b>RESULTS</b>All the 96 lumps were histologically diagnosed as fat necrosis. They were lipo-necrotic cysts with thin wall(29 lumps), or thick wall(52 lumps), or no wall(15 lumps). The cysts with wall could be distinguished both in the images of ultrasound and mammography, but the cysts without wall could only be found in mammography images, not in ultrasound images.</p><p><b>CONCLUSIONS</b>Most fat necrosis lesions show a special cystic images with thin or thick wall in ultrasound and mammography. Irregular lesions without wall can be distinguished in the mammography images, but may be mis-diagnosed in the images of ultrasound. The images characters of fat necrosis lesions in mammography are not confused with the breast tumor.</p>

Pedestrian mortality between 2006 and 2010 in China: findings from non-police reported data / 生物医学与环境科学（英文）

Pedestrian safety in China is an important but largely neglected issue, in part due to the substantial under-reporting within police data. In this study we aimed to examine changes in pedestrian fatality between 2006 and 2010 in China using non-police reported data. A multi-year study was conducted based on the mortality data during 2006-2010 from the Disease Surveillance Points (DSP) data in China. Between 2006 and 2010, the crude pedestrian mortality increased from 7.0 to 10.5 per 100 000 populations. Annual pedestrian mortality from DSP data was 13 times in 2006 and 55 times in 2010 mortality for pedestrians and passengers from police-reported data in the corresponding years. After controlling for sex, age, and urban/rural, the mortality increased by 44% from 2006 to 2010 (adjusted mortality rate ratio (MRR)=1.11, 95% CI 1.10-1.12). The problem of pedestrian deaths is much more serious in China than that officially reported by the police. Significant and urgent efforts are needed to save lives of pedestrian in China.

The application of undermining orbicularis oculi muscle from orbital rim for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the role of undermining orbicularis oculi muscle from Orbital rim for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty.</p><p><b>METHODS</b>56 cases of lower eye baggy deformity with tear trough deformity and palabromalar groove were treated with the procedure of stripping eye orbicularis oculi muscle from orbital rim by a transcutaneous approach in lower blepharoplasty. The orbital septum was opened along the arcus marginalis for releasing the orbital fat. Some orbital fat was removed if necessary. Then the inferior edge of the orbital septum fat was reset over the orbital rim so as to smooth the infraorbital groove.</p><p><b>RESULTS</b>56 patients were available for 6 to 18 month's follow-up. 54 patients were quite satisfied with the cosmetic result. One developed lower eyelid retraction and another one showed asymmetrical subcutaneous local uneven after 1 month's. They were all corrected by the second operation after 3 months.</p><p><b>CONCLUSIONS</b>Stripping orbicularis oculi muscle from orbital rim plays an important role for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty.</p>

Integrated autologous fat graft in face recontouring / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the integrated autologous fat graft technique in face recontouring.</p><p><b>METHODS</b>In this study we treated 83 cases of face recontouring with 3L3M technique (low pressure suction, low speed centrifugation, low volume, multi-plane, multi-tunnel, multi-point injection). Each case was treated 1-3 times and the interval period is 3-6 months. The result was based on comparing the photos taken from pre-operation and post operation, observing the expression recovery, cysts, local absorption, and patients self evaluation.</p><p><b>RESULTS</b>Long time follow up showed that fat graft can be alive in the recipient site for long time after 1-3 times autologous fat injection. More than 73.5% patients were satisfactory with the curative effect while less than 4.8% patients were unsatisfactory.</p><p><b>CONCLUSION</b>3L3M integrated fat graft technique is an effective and safe treatment in face recontouring.</p>

Comparison of the effect of local administration of endothelial progenitor cells and VEGF on improving neovascularization in flap prefabrication / 中华整形外科杂志

<p><b>OBJECTIVE</b>To compare the effect of local administration of endothelial progenitor cells (EPCs) and VECF on improving neovascularization and augmenting the survival areas in a rat model of prefabricated flap.</p><p><b>METHODS</b>Prefabricated flaps were created by ligating the right femoral vascular pedicle and implanting it underneath the abdominal flap. The in vitro cultured EPCs (Group I , n=15) and VEGF protein (Group II , n=15) were injected subcutaneously around the implanted pedicle in experimental groups. PBS was injected in control group (Group Ill , n=15). 4 weeks later, the abdominal island flap based solely on the implanted vessels was elevated and sutured back. Then flap viability and numbers of capillary were evaluated on day 7.</p><p><b>RESULTS</b>There was more statistically significant augmentation of flap survival [(87.26 +/- 10.13) % versus (66.13 +/- 9.9)% and (55.59 +/- 13.06)%, P < 0.001], a higher capillary density (38.67 +/- 9.52 versus 25.83 +/- 6.33 and 26.5 +/- 5.61 capillary/mm2 , P < 0.05) in EPCs group than in the other two groups.</p><p><b>CONCLUSIONS</b>EPCs are superior to VEGF in improving neovascularization during flap prefabrication. Local transplantation of bone marrow-derived EPCs may be a useful strategy for augmentation of the survival areas of prefabricated flaps.</p>

Cervicothoracic prefabricated flaps for reconstruction of face and neck / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a new prefabricated flap with matched colour, texture, thin enough thickness, large enough dimension and reliability for reconstruction of massive defect of face and neck.</p><p><b>METHODS</b>The patients with massive scar of face and neck were selected for treatment with prefabricated flap. Flap prefabrication involved two stages. The "sandwich" structure including the descending branch of the lateral femoral circumflex vessels and surrounding muscle fascia was harvested from the thigh and anastomosed to superior thyroid artery or facial vessels. Flap prefabrication was performed by inserting the fascia flap between the cervicothoracic skin and the tissue expander placed beneath the skin. After a period of expansion, the flap was transferred to the recipient site based on the implanted vessels. The results including complications were examined during follow-up.</p><p><b>RESULTS</b>Nine patients received this treatment. The average dimensions of fascia flap harvested was 6.3 cm x 11.2 cm. After mean interval of 16.7 weeks, the expanders were filled to a mean volume of 1670cc. The size of prefabricated flap ranged from 12 cm x 15 cm to 15 cm x 32 cm. In all cases, the flap efficiently covered the entire defect of the face and neck, and the donor site of the flap is closed primarily. All of the flaps developed venous congestion in some degree after the second operation. Partial flap necrosis occurred in two cases. Three flap was thinned to contour the bulky pedicle. During follow-up, the transferred flap was matched well to the adjacent skin. The reconstructed face restored nature contour and expression. Muscle weakness or paraesthesia was not found in the donor thigh.</p><p><b>CONCLUSIONS</b>Cervicothoracic Prefabricated Flap, is reliable and versatile in the reconstruction of massive soft tissue deficits with restoration nature surface and expression of the face and neck.</p>

Reconstruction of the acquired orbital deformities / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the reconstruction of acquired orbital deformities.</p><p><b>METHODS</b>Through coronal incisions, subciliary incisions and buccal sulcus incisions, or periorbital wound, the displaced orbital walls were repositioned after osteotomy. And the mandibular outer cortex was used to repair the bone defect, so as to restore the orital integrity.</p><p><b>RESULTS</b>From Sept. 2002 to Jun. 2006, 64 patients with acquired orbital deformities were treated. The integrity of orbit and eyeball location recovered very well.</p><p><b>CONCLUSIONS</b>Restoration of the orbital integrity is the key to the treatment of acquired orbital deformities. The periorbital deformities should be corrected after osteotomy with mandibular outer cortex for bone defect.</p>

Three case reports of abdominal compartment syndrome after full abdominoplasty / 中华整形外科杂志

<p><b>OBJECTIVE</b>To improve the safety of the abdominoplasty by the study of the complication of abdominal compartment syndrome after abdominoplasty.</p><p><b>METHODS</b>Three cases were analyzed and discussed respectively in aspects of clinic symptoms, pathological reason, treatments and follow-up results. The treatment was the incision of musculoaponeurotic system, which usually cause defect of abdominal wall after pressure releasing. The defect of musculoaponeurotic system was reconstructed by Mesh, and the defect of skin was repaired by skin graft.</p><p><b>RESULTS</b>The pathologic change of the complications was the shrinking of the belly cavity's volume and the increasing internal pressure of the abdomen caused the internal pressure of the thoracic cavity increase. The clinical manifestations included compressive feelings of chest and abdomen, high urinary frequency and psychiatric symptom. 2 patients accepted the operation. The abdominal compartment syndrome disappeared after the operation, and the results of the two years follow-up were satisfied.</p><p><b>CONCLUSIONS</b>Full abdominoplasty has the risk of causing abdominal compartment syndrome. This complication can be cured by decompression of abdominal wall. The effect is stable after long time's follow-up. Special preventive methods should be used in high-risk patients to avoid this complication.</p>

Repair of nasal lining in nasal reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To present a variety of techniques for providing nasal lining and discuss the application of these methods to specific nasal defects.</p><p><b>METHODS</b>Regard of the nasal defect's location, size, or depth of involvement, the approaches were used with turnover nasal skin or scar flaps (n=17), the buccal mucosal flap (n=1), the nasolabial flaps (n=5), prefabricated flaps (n=1) for lining. A formal nasal reconstruction was then carried out with use of rib cartilage grafts for support and a forehead flap for cover.</p><p><b>RESULTS</b>Necrosis of forehead flaps and lining tissues did not occur. 24 Cases have been followed for a 6-34 months period. Except some turnover scar flaps obstructed the airway and needed aggressive secondary surgical thinning, the other lining flaps remained stable from adequate restoration of form and function.</p><p><b>CONCLUSIONS</b>It is important to evaluate the exact sizes, volumes and layers missing of the nasal defects before rebuilding the lining defect. Choosing the adequate operation can provide good aesthetic and functional results. The prefabricated flap is good to be used to reconstruct nasal lining in complicated cases.</p>

Anatomic study of supratrochlear artery and its application in nasal reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the anatomy of the cutaneous branch (CB) of supratrochlear artery and its relevance to the design of frontal flap in nasal reconstruction.</p><p><b>METHODS</b>10 fresh cadavers were dissected to study the position and course of the CB of supratrochlear artery (supraorbital rim and facial midline as landmark). The communication between the CB and supraorbital artery was also studied. 5 cases of ultra-thin frontal flaps and 11 cases of bi-flap( cutaneous flap and muscular flap) were designed on anatomic basis. The survival rate of flap, the stability and aesthetic appearance of the reconstructed nose were followed up.</p><p><b>RESULTS</b>The supratrochlear artery gave off constant CB (1.18 +/- 0.36) cm from upper orbital rim and (1.35 +/- 0.34) cm from the midline of face. The CB passed in a subcutaneous plane and communicated with the bilateral muscular branch, CB of the opposite side and bilateral supraorbital artery. The supratrochlear artery only had CB with no muscular branch in 3 cases. All the flaps survived completely except one with blister on the nose tip which healed spontaneously. The postoperative aesthetic appearance was very satisfactory.</p><p><b>CONCLUSIONS</b>The supratrochlear artery has constant CB. The frontal ultra-thin flap pedicled with the CB can improve the therapeutic effect of nasal reconstruction.</p>

Application of aesthetic sub-unit principle in nasal reconstruction and repairing of nasal defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the significance and effect of nasal aesthetic sub-unit principle.</p><p><b>METHODS</b>Based on nasal aesthetic sub-unit, 27 patients were divided into 5 groups according to their nasal defects. They were nasal dorsum, tip, alar lobule, soft triangle and two or two above nasal subunit defects groups. Local restore were applied in defects which were less than 50 percent of one nasal subunit. Total nasal subunit reconstruction were applied, if areas of defects were larger than 50 percent of one nasal subunit 10 cases were received free tissue transplantation (including free skin transplantation, composite auricle transplantation, etc), 4 cases were received local flap, and 13 cases were received forehead flap. Following up for 5 to 37 months, evaluation item were contour and color.</p><p><b>RESULTS</b>Skin transplantation and local flap were all survived. Auricle composite flap were all survived except for 2 cases whose epidermis looked red and purple. These two case's epidermis regained normal 6 months after operation. Forehead flap for nasal reconstruction were all survived, but one of them had to perform secondary surgery for coverage of the exposed nasal frame. 27 cases were followed up in all. Patients and their family members were satisfied with the nasal's contour and color.</p><p><b>CONCLUSIONS</b>Good aesthetic effects comes from nasal aesthetic sub-unit principle in nasal reconstruction and repairing of nasal defects.</p>

Establishment of composite facial and scalp allograft transplantation model in canine / 中华整形外科杂志

<p><b>OBJECTIVE</b>To develop an experimental model of composite facial and scalp allograft in canine in order to investigate technical and immunological aspects and functional recovery of facial muscles of this new approach to facial reconstruction.</p><p><b>METHODS</b>(1) Anatomic study: Four mongrel dogs were used for anatomical dissection of the head and neck region and for harvesting flap experiment. (2) Autologous transplantation (group I): Three types composite facial and scalp autologous transplantation were performed in five mongrel dogs. Type I composite tissue flap (group I a n = 2) included bilateral external ear and orbicularis oculi muscle. Type II (group I b n = 1) included single-lateral external ear, orbicularis oculi muscle, external nose upper and lower lip. Type III (group I c n = 2) included single - lateral external ear and orbicularis oculi muscle. (3) Allograft transplantation (group II): In group II a (n = 2), two allograft transplantation were performed with type III composite facial and scalp . In group II b (n = 4), four allograft transplantation were performed with the modified type III composite facial and scalp which included single - lateral external ear, orbicularis oculi muscle and one third of inferior tarsal plate and palpebral conjunctiva. To prevent allograft rejection, Cyclosporin A (CsA) and Methylprednisolone (MP) or Prednisone (PS ) were combined used as immunosuppressive protocol . Dose of CsA was adjusted depending on its blood drug level. Electromyogram (EMG) of orbicularis oculi muscle was carried out at 4 weeks, 6 weeks, 12 weeks and 6 months postoperation.</p><p><b>RESULTS</b>(1) The facial anatomic characteristic of dog is similar to that of human being, external carotid artery and external jugular vein afford good blood supply to composite facial and scalp. (2) The dogs in group I c were long-term surviving with leakage of salivary juice. (3) In group II a (n = 2), one dog presented rejection reaction at 28th day postoperation, the reversal of rejection was achieved by increasing the dose of CsA and prednisone and with topical clobetasol for 2 weeks, the dog survived indefinitely( > 309 days). In group II b (n = 4), there were three dogs survived indefinitely ( > 159 days, > 129 days, > 108 days) without complication, EMG showed the function of orbicularis oculi muscle was gradually improving.</p><p><b>CONCLUSION</b>The modified type III composite facial and scalp allograft transplantation model is an ideal model for facial allograft transplantation study.</p>

Strategy study of harvesting total facial flap and donor choice for allograft transplantation in cadaver / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the operational strategy of harvesting total facial allograft by autopsy.</p><p><b>METHODS</b>Twelve fresh human cadavers were dissected. They were divided into two groups randomly. The total facial-scalp flap of the group I was elevated by the bi-pedicle method, the group II was operated with single-pedicle method. Both were dissected at the deep plane of the SMAS. : the time of facial flap harvesting, length of the artery vein and nerve pedicles of the donor were measured and marked, after operation, in each group we transferred one facial allograft to another. Then the free graft of group I was poured through artery by methylthioninium chloride to study vascular territories.</p><p><b>RESULTS</b>Mean harvesting time of the group I (46 +/- 11) minutes, group II (111 +/- 7) minutes, P < 0.01. Perfusion result shows that unilateral superficial temporal artery and the opposite side of the facial artery can supply blood for whole face. The pedicle was long enough for anastomosis. Post-operation appearance: the face looks like neither the donor nor the recipient primarily, It's mainly due to the characteristics of the skeleton and the soft tissues.</p><p><b>CONCLUSIONS</b>The bi-pedicle method of the harvesting total facial allograft is concise, fast, safe can be widely applied in clinical.</p>

Research of the preservation of the composite facial allograft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effective method of preserving composite facial allograft so as to attenuate ischemic injury.</p><p><b>METHODS</b>The composite facial allografts were harvested from dog, perfused and preserved with 4 degrees C physiological sodium chloride and UW solution respectively. Immediately after the removal of the flap, after 12, 24, 48 h of preservation, MTT assay was used to determine the viability of several kinds of tissue, including skin, mucosa, muscle, bleed vessel, nerve and gland. The results of the two groups were compared in term of viability percentage. The pathology of several tissues were observed after 24 and 48 h of storage.</p><p><b>RESULTS</b>The viability percentage of every tissue conserved in UW solution for 48 hours was more than 75%. There was significant difference between physiological sodium chloride group and UW group (P < 0.05). Some changes, including Porous arrangement of fibers in connective tissue of skin and mucosa, hyalinization of tissue around the hair follicle and edema of cell in hair follicle, enlargement of space between muscle bundles and unclearness of boundary of acinus could be seen in physiological sodium chloride group while no significant change in UW group.</p><p><b>CONCLUSIONS</b>UW solution could be considered as preservation solution for composite facial allograft.</p>

Detection of Rickettsia prowazekii by quantitative real-time PCR / 中华流行病学杂志

<p><b>OBJECTIVE</b>To develop a quantitative real-time polymerase chain reaction (PCR) for detecting Rickettsia prowazekii.</p><p><b>METHODS</b>Primers and TaqMan-MGB probes designed based on ompB gene of R. prowazekii, were used to develop this method.</p><p><b>RESULTS</b>For the quantitative real-time PCR, the relationship between the values of threshold cycle (Ct) and the DNA copy number was linear (r = 0.999) and the sensitivity was about 100 times higher than that of the nested PCR for detecting the same DNA sample. The results of the genomic DNA samples of other rickettsial and bacterial agents detected by real-time PCR were all negative. DNAs extracted from blood samples of guinea pig infected with R. prowazekii were examined by real-time PCR and the positive results were obtained from some of these samples. However, the results of some samples in nested PCR assay were all negative.</p><p><b>CONCLUSION</b>These results suggested that the real-time PCR was highly specific and sensitive for detection of R. prowazekii that was useful for the detection of tiny DNA of R. prowazekii in blood samples from patients suspected of having epidemic typhus.</p>

Study on the development of a real-time quantitative polymerase chain reaction assay to detect Rickettsia / 中华流行病学杂志

<p><b>OBJECTIVE</b>To develop a real-time quantitative polymerase chain reaction(PCR) assay for detecting Rickettsia rickettsii.</p><p><b>METHODS</b>The primers and TaqMan-MGB probe were designed according to the ompB gene of R. rickettsii. A DNA fragment of ompB gene amplified from R. rickettsii by PCR was used as a standard template for the development of the method.</p><p><b>RESULTS</b>5 copies of ompB fragments of R. rickettsii were detected. The genomic DNA of R. rickettsii was detected by the developed quantitative PCR assay. However, the genomic DNA from another rickettsial or bacterial agent was not determined. Through this developed method, the positive results were obtained from the animals and cells, artificially infected with R. rickettsii.</p><p><b>CONCLUSION</b>The real-time quantitative PCR assay seemed to be highly sensitive and specific which might be used to rapidly detect R. rickettsia DNA in various samples and to early diagnose patients infected by R. rickettsii.</p>

Restore hand's function after electric injuries at the wrist by a free composite flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a new free composite flap for the treatment of electric injuries of hands, which can repair the skin, blood vessels, tendons and nerves injuries in just one operation. It may improve the prognosis of electric hand injuries.</p><p><b>METHODS</b>5 patients with electric injuries at wrist were treated by the free composite flap. The procedure is followed: The composite flap was harvested from medial lateral crural skin flap. Its blood supply was from tibial posterior vessels. The perforans arteries to flap and the branches to plantaris were preserved, and the nerve suralis and tendon plantaris were compound into the flap by carefully dissection of crural fascia. At the same time, 3-4 tendons of extensor digitorum longus were inserted into the superficial crural fascia. Thus, blood vessels, nerves and tendons were combined into the flap before transplantation. The composite flap was then transplanted into the recipient site of the electric injuries of hand to repair the long defects of the skin, blood vessels,nerves and tendons in one operation. The evaluation methods of the prognosis are the follows: the active motion function of finger was assessed by flexion and extension function of the fingers. The sensibility function was tested by the standards recommended by British Medical Association.</p><p><b>RESULTS</b>The patients were followed up from 3 to 12 months. All the flaps were survived. Six months after operation, the flexion distance from tip to palmar crease and extension distance from tip to horizontal level of 3 patients were 4-5 cm and 3-4 cm respectively, and the other 2 patients were recovered from 6 cm and 5 cm to 4 cm and 4 cm respectively. The sensibility of finger skin reached to S2 level, and skin temperature rose.</p><p><b>CONCLUSION</b>The free medial lateral crural composite flap was an ideal one to cure electric injuries at wrist, for it repairs skin, nerves, vessels and tendons defects in just one operation.</p>