Plateau iris / 国际眼科杂志(Guoji Yanke Zazhi)

Primary angle closure glaucoma(PACG)is the leading type of glaucoma in Asia, especially in China. PACG still has a high proportion of angle closure after laser peripheral iridectomy(LPI). Plateau iris is one of the non-pupillary blockage factors that cause angle closure. With the wide application of ultrasound biomicroscopy(UBM)in ophthalmology, the understanding of plateau iris has been deepened continually. This paper will elaborate the concept, mechanism, prevalence, relationship with angle closure, diagnostic criteria and the treatment of plateau iris, aiming to have a deeper understanding of the relationship between plateau iris and PACG, and to provide references for the treatment and research of PACG in the future.

Astragali Radix-Curcumae Rhizoma combination inhibits proliferation, migration, and invasion of colon cancer HT-29 cells by regulating EMT / 中国中药杂志

This study aims to investigate the effect of Astragali Radix-Curcumae Rhizoma(AC) combination on the proliferation, migration, and invasion of colon cancer HT-29 cells based on epithelial-mesenchymal transition(EMT). HT-29 cells were respectively treated with 0, 3, 6 and 12 g·kg~(-1) AC-containing serum for 48 h. The survival and growth of cells were measured by thiazole blue(MTT) colorimetry, and the proliferation, migration, and invasion of cells were detected by 5-ethynyl-2'-deoxyuridine(EdU) test and Transwell assay. Cell apoptosis was examined by flow cytometry. The BALB/c nude mouse model of subcutaneous colon cancer xenograft was established, and then model mice were classified into blank control group, 6 g·kg~(-1) AC group, and 12 g·kg~(-1) AC group. The tumor weight and volume of mice were recorded, and the histopathological morphology of the tumor was observed based on hematoxylin-eosin(HE) staining. The expression of apoptosis-associated proteins B-cell lymphoma-2-associated X protein(Bax), cysteine-aspartic acid protease-3(caspase-3), and cleaved caspase-3, and EMT-associated proteins E-cadherin, MMP9, MMP2 and vimentin in HT-29 cells and mouse tumor tissues after the treatment of AC was determined by Western blot. The results showed that cell survival rate and the number of cells at proliferation stage decreased compared with those in the blank control group. The number of migrating and invading cells reduced and the number of apoptotic cells increased in the administration groups compared with those in the blank control group. As for the in vivo experiment, compared with the blank control group, the administration groups had small tumors with low mass and shrinkage of cells and karyopycnosis in the tumor tissue, indicating that the AC combination may improve EMT. In addition, the expression of Bcl2 and E-cadherin increased and the expression of Bax, caspase-3, cleaved caspase-3, MMP9, MMP2, and vimentin decreased in HT-29 cells and tumor tissues in each administration group. In summary, the AC combination can significantly inhibit the proliferation, invasion, migration, and EMT of HT-29 cells in vivo and in vitro and promote the apoptosis of colon cancer cells.

Therapeutic Efficacy of Acupuncture at Baihui (GV 20) and Shenting (GV 24) for Post-stroke Cognitive Impairment: A Systematic Review / 上海针灸杂志

Objective To evaluate the clinical efficacy of acupuncture at Baihui (GV 20) and Shenting (GV 24) in treating post-stroke cognitive impairment (PSCI) by using the systematic review method.Method Via computer, Chinese Journal Full-text Database (CJFD), Wanfang, China Biology Medicine disc (CBMdisc), Chinese Science and Technology Periodical Database, PubMed, Foreign Evidence-Based Medicine (FEMB), the Cochrane Library were retrieved.Chinese Acupuncture and Moxibustion andShanghai Journal of Acupuncture-moxibustion were manually retrieved. Randomized controlled trials published before Jan 31st of 2013 on acupuncture at Baihui (GV 20) and Shenting (GV 24) in treating PSCI, both in Chinese and English, were collected. The required data were extracted, then were evaluated according to the criteria of Cochrane systematic review and underwent meta-analysis by using RevMan 5.0.Result Twenty-two clinical trials were finally recruited, including 1637 subjects. The meta-analysis showed that acupuncture at acupoints including Baihui (GV 20) and Shenting (GV 24) produced a more significant rehabilitation result compared to single rehabilitation training or medication. The comparison of Mini-Mental State Examination (MMSE) score showed: [WMD=3.37, 95％CI (1.70, 5.05),P<0.00001]; the comparison of P300 latency: [WMD=1.22, 95％CI (0.84, 1.59),P<0.00001]. Severe adverse reactions were not discovered. Conclusion Acupuncture at Baihui (GV 20) and Shenting (GV 24) can effectively improve the cognitive function of PSCI patients. However, the diagnostic criteria and evaluation indexes are expected to be unified and standardized, and the clinical trials on acupuncture intervening PSCI are required to be further improved methodologically.

Effect of intraoperative hypothermia therapy on immune function and recovery of neurological function in elderly patients with acute intestinal obstruction during perioperative period / 中国基层医药

Objective To investigate the effect of intraoperative hypothermia therapy on immune function and neurological function recovery in elderly patients with acute intestinal obstruction.Methods 80 elderly patients with acute intestinal obstruction were selected,and they were randomly divided into two groups according to the digital table,40 cases in each group.The control group was treated with conventional symptomatic support.The observation group was treated with intraoperative hypothermia therapy.The CD4+,CD8+,CD4+/CD8+ and the levels of ESS and Barthel index in the two groups after intervention were observed.Results The levels of CD4+,CD8+ in the observation group were higher than those in the control group(t =26.242,23.908,all P ＜0.05),CD4+/CD8+ was lower than that in the control group(t =5.262,P ＜0.05).The levels of IgM,IgG and IgA in the observation group were higher than those in the control group (t =52.623,28.342,53.126,all P ＜0.05).The ESS and Barthel index of the observation group were higher than those of the control group (t =11.486,10.902,all P ＜ 0.05).Conclusion Mild hypothermia can reduce the immune function of elderly patients with acute intestinal obstruction,promote the recovery of nervous system and improve the postoperative quality of life.

Interhemispheric synchrony differences between multiple system atrophy (Parkinsonian type) and Parkinson's disease / 中华神经科杂志

Objective To investigate the resting-state functional connectivity of the two hemispheres between multiple system atrophy (Parkinsonian type,MSA-P) and Parkinson's disease (PD).Methods A total of 25 MSA-P,29 PD patients and 29 well-matched healthy controls recruited in the Nanjing Brain Hospital Affiliated to Nanjing Medical University from June 2013 to December 2015 were scanned with resting-state functional magnetic resonance imaging for voxel mirrored homotopic correlation (VMHC) analysis.The Mini Mental State Examination,Montreal Cognitive Assessment,Frontal Assessment Battery and Unified Parkinson's Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) were used to assess the clinical symptom.Then the relationship between the change of VMHC values and severity of clinical symptoms was investigated.Results Compared with healthy controls,MSA-P and PD patients both showed decreased VMHC in bilateral cerebellum posterior lobe,precuneus gyrus,middle temporal gyrus,and postcentral gyrus.Compared with PD or healthy controls,MSA-P patients exhibited lower VMHC in bilateral putamen.Significant negative correlation between VMHC values of putamen and UPDRS-Ⅲ scores was found in MSAP patients (r =-0.607,P =0.001).Conclusion These functional changes suggest that the abnormal interhemispheric synchrony probably plays an important role in pathophysiology of both MSA-P and PD,and abnormal VMHC values in putamen of MSA-P may be helpful in differentiating MSA-P from PD.

Two flaps based on the proximal and distal perforator from ulnar artery in the repair of defect of two fin-gers / 中华显微外科杂志

Objective To study the clinical application of the 2 flaps based on the proximal and distal perfo-rator from ulnar artery in the repair of defect of 2 fingers and evaluate the outcome of the procedures. Methods From January,2014 to January,2015, 8 cases with skin and soft tissue defects of 2 fingers were treated simultaneous-ly with the distal and proximal perforator flap of ulnar artery in ipsilateral limb. The area of the distal flaps ranged from 2.5 cm×4.5 cm to 4.0 cm×6.5 cm. The area of the proximal flaps ranged from 3.5 cm×4.5 cm to 4.5 cm×6.5 cm. The followed-up were performed at 3rd, 6th and 12th months post-operation. The patients' satisfaction of the appear-ance and function of repaired finger and working situation were investigated. The postoperatively pain prick , touch and temperature sensation of the flaps were examined. Total active range of motion (TAM) of the finger points were measured. Results All flaps survived. Two flaps got plastic surgery at 5 months post-operation. The pain , tempera-ture and light touch sensation were restored 12 months after the surgery. Five patients returned to work again 12 months after the operation. Conclusion The distal and proximal perforator flap has their own characteristics, can be used simultaneously to repair skin and soft tissue defects of the two fingers.

A comparative study of two kinds of reverse radial flap for thumb soft tissue reconstruction / 中华显微外科杂志

Objective To evaluate the clinical results of the thumb dorsoradial flap and the greater thenar flap for coverage of thumb soft tissue defect,and to provide guidance on clinical selection of flaps.Methods From January,2013 to June,2014,23 thumb dorsoradial flaps and 20 greater thenar flaps were used to repair the soft tissues defects in thumbs and were followed up to compare the results.Patient satisfaction,cold intolerance scores,TAM of the reconstructed thumb,sensation (pain and temperature sensation,Semmes-Weinstein monofilament test,static two-point discrimination) and blood perfusion of the flaps were recorded and analyzed statistically.Results Thumb dorsoradial flaps group:patient satisfaction was (36.97 ± 7.70)％,cold intolerance score was 58.96 ± 12.47,TAM of the thumb was (87.57 ± 12.83)°,median Semmes-Weinstein monofilament test was 3.61mm,static two-point discrimination was (14.22 ± 2.84)mm,and blood perfusion was (98.41 ± 15.66) PU.Greater thenar flaps group:patient satisfaction was (50.00 ± 10.80)％,cold intolerance score was 60.45 ± 14.10,TAM of the thumb was (95.00 ± 14.58)°,median Semmes-Weinstein monofilament test was 4.31mm,static twopoint discrimination was (20.70 ± 2.56)mm,and blood perfusion was (104.74 ± 14.12)PU.The greater thenar flap had a larger degree of satisfaction than the dorsoradial flap (P ＜ 0.05).Both pain and temperature sensation of the flap were regained in all cases,but the dorsoradial flap presented better Semmes-Weinstein monofilament score and static two-point discrimination(P ＜ 0.05).No differences were found regarding TAM of the thumb,cold intolerance score and blood perfusion of the flap (P ＞ 0.05).Conclusion The dorsoradial flap is suitable for repairing the thumb pulp defect due to its good sensation.For the small defect of non-functional dorsal area,the greater thenar flap will be a satisfactory method.

Risk factors of the failure in digit replantation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the relative factors on the failure in digit replantation in order to take preventions to control the risk factors.</p><p><b>METHODS</b>From January 2013 to December 2013, 236 consecutive patients (311 fingers) underwent digit replantation were collected to analyze retrospectively, involving 183 males and 53 females with an average age of 34.5 years old ranging from 2 to 62 years old (6 cases under 6 years old and 230 cases elder than 6 years old). There were 51 thumbs, 87 index fingers, 78 middle fingers, 63 ring fings and 32 little thumbs. Forty cases(forty fings) who were failured as the observation group, the others as the control group. The factors of age, gender, finger, cause of injury, smoking history, ischemia duration, plane of division, condition of venous drainage and condition of arterial repair we assessed.</p><p><b>RESULTS</b>All 236 cases with 311 fingers were replanted, 40 fingers were failured after operation. The relative factors on the failure in digit replantation included smoking history, cause of injury, plane of division, condition of venous drainage and condition of arterial repair (P< 0.05). There were no significant correlation between the failure and age, gender, finger and ischemia duration (P>0.05).</p><p><b>CONCLUSION</b>Smoking history, causes of injury, plane of division, condition of venous drainage and condition of arterial repair are risks of failure in digit replantation. Before choosing the type of operation, it should be think about the patient's general conditions, injury status, grasp firmly the operative indications and actively carry out surgical treatment.</p>

Efficacy observation of acupuncture bloodletting and penicillin on treatment of children acute tonsillitis / 中国针灸

<p><b>OBJECTIVE</b>To observe differences of therapeutic effects among acupuncture bloodletting, penicillin and acupuncture bloodletting combined with penicillin for children acute tonsillitis and providea better treatment method in cli nic.</p><p><b>METHODS</b>Seventy-five mild cases were selected into section of mild symptoms while seventy-five severe cases were selected into section of severe symptoms. Cases in the two sections then were divided into, an acupuncture bloodletting group, a penicillin group and a comprehensive group by random digital table method separately, 25 cases in each one. Qu-chi (LI 11), Hegu (LI 4), Dazhui (GV 14), Shaoshang (LU 11) and Erjian (EX 11) were selected in the acupuncture bloodletting group, intravenous injection of penicillin sodium was applied in the penicillin group and acupuncture bloodletting combined with penicillin was applied in the comprehensive group. Efficacy assessment was conducted after 3 days in the section of mild symptoms and after 5 days in the section of severe symptoms.</p><p><b>RESULTS</b>For the section of mild symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group and 92.0% (23/25) in the acupuncture bloodletting group, which were both superior to 68. 0% (17/25) in the penicillin group (P<0.05), but no statistical significance was seen between the comprehensive group and acupuncture bloodletting group (P>0.05). For the section of severe symptoms, the total effective rate was 96.0% (24/25) in the comprehensive group, which was obviously superior to 60.0% (15/25) in the acupuncture bloodletting group (P<0.01) and 68.0% (17/25) in the penicillin group (P<0. 05), and no statistical significance was seen between the acupuncture bloodletting group and penicillin group (P>0.05).</p><p><b>CONCLUSION</b>The efficacy of acupuncture bloodletting combined with penicillin is little different from that of acupuncture bloodletting for treatment of children acute tonsillitis with mild accompanied symptoms, which were both superior to intravenous injection of penicillin sodium. For severe accompanied symptoms, the efficacy of acupuncture bloodletting combined with penicillin is obviously superior to acupuncture bloodletting and penicillin.</p>

Relationship between appositional angle closure and darkroom provocative test in fellow eyes of acute primary angle closure after laser peripheral iridotomy / 中华实验眼科杂志

BackgroundLaser peripheral iridotomy(LPI) can break the pupillary block,and is an effective method of treating acute primary angle closure (APAC).However,a part of APAC eyes may gradually develop a formation and extension of peripheral anterior synechia(PAS) and increased intraocular pressure(IOP) after LPI.ObjectiveTo investigate the relationship between appositional angle closure and darkroom provocative test(DRPT) in the fellow eyes with APAC after LPI.Methods Fellow eyes of APAC without PAS after LPI were studied.Ultrasounic biomicroscopy(UBM) were performed in darkness to observe whether appositional angle closure occurred and compare the relationship between the quadrants with appositional angle closure and the results of DRPT.Results Fifty-four patients were included in the study.Appositional angle closure was observed in at least one quadrant in 20(37.0％ ) of the 54 fellow eyes with APAC after LPI.Fifty-one patients were given DRPT and positive result in 9 patients( 17.6％ ).According to the quadrants with appositional angle closure,there were 5 patients with DRPT positive results in 46 patients with appositional angle closure 0 to 2 quadrants,and 4 patients with DRPT positive results in 5 patients with appositional angle closure 3 to 4 quadrants ( P =0.003 ).Bivariate correlation analysis indicated a positive correlation between the value of the increased IOP in DRPT and the number of quadrants with appositional angle closure in darkness( r =0.397,P =0.004).ConclusionsA certain proportional fellow eyes of APAC appeared appositional angle closure in darkness and DRPT positive result after LPI.The more the quadrants of appositional angle closure after LPI,the greater the likelihood of a positive DRPT.It suggests that the APAC fellow eyes and attack eyes with the same anatomical configuration still have the possibility of angle closure after LPI,and need follow-up and treatment for a long time.

Change of vascular endothelial progenitor cell in acute angle-closure glaucomatous patient / 中华实验眼科杂志

Background The circulating endothelial progenitor cells (EPCs)play an important role in postnatal vasculogenesis and restoration of endothelial injury.Previous investigation illustrated that a reduced ocular blood flow and vascular dysfunction caused by endothelial dysfunction plays a role in the pathogenesis of glaucoma.However,endothelial system accommodation is accomplished with the circulating EPCs.Objective The present trail was to investigate EPCs change in patients with primary acute angle-closure glaucoma (PACG)and explore the role of EPCs in the pathogenesis of PACG. MethodsA prospective cohort study was designed.Thirty patients with PACG were enrolled in Tianjin Medical University General Hospital as PACG group,and 20 normal subjects served as control group.Periphery bloodsamples were obtained fromall the patients and thenstained with saturating concentrations of monoclonal antibodies,FITC-conjugated anti-CD34 and CD133 mAb.EPCs identified by CD34,CD133 were enumerated by flow cytometry,and the correlation between EPCs change and its relative factors was analyzed.Informed consent was obtained from each subject before any medical procedure. Results No significant differences were found in age,gender,vascular-related risk factor,blood biochemical indicators between PACG group and normal contol group(P＞0.05 ),but a higher intraocular pressure( IOP)was displayed in PACG group compared with normal control group ( P =0.00 ).The numbers of EPCs were ( 48 ± 22 ) cells/ml in PACG group and ( 65 ± 20 )cells/ml in normal control group with a significant difference between them (P=0.004).In PACG group,the numbers of EPCs were(60± 19 )cells/ml and (34 ±7 )cells/ml respeetively in phase 1 and phase 3 of optical nerve damage (Z=-3.015,P=0.002 ).There was a negative correlation between EPCs numbers and baseline IOP within a certain range( r=-0.835,P＜0.05 ).However,no obvious correlations were seen between EPCs numbers and blood lipid Level,blood glucose level or glaucoma course ( r =0.343,P =0.227 ; r =-0.203,P =0.419 ; r =0.198,P =0.610 ).The EPCs numbers in PACG patients with cardiovascular disease were(56±22)cells/ml and that of without PACG were (35± 15 ) cells/ml( P =0.005 ). ConclusionsThe numbers of EPCs decrease in PACG patient.These results imply that EPCs might play role during the restore of the optical nerve damage in PACG eye.

Lateral crural reverse island skin flap with two sets of blood supply system for soft tissue defect of ankle and foot / 中华显微外科杂志

ObjectiveTo introduce clinical experience of the modified lateral crural reverse island skin flap with two sets of blood supply system for aged ankle & foot soft tissue defect.MethodsOn the anatomy base that cutaneous artery branches of lateral crural reverse island skin flap and perforating branches of sural neurocutaneous vascular flap were originated from peroneal artery, we designed the modified lateral crural reverse island skin flap located in posterolateral cruris treated for aged ankle & foot soft tissue defect. The modified flap had two sets of blood supply system which were from lateral crural flap and sural neurocutaneous flap.ResultsAll 11 flaps survived. The skin grafting of donor sites healed well. Followed up 3-9 months, six cases were satisfactory. Five cases with extensor defect were regained by tendon transplantation after 3 months of the operations.Conclusion The modified lateral crural reverse island skin flap with two sets of blood supply system is a good method for aged ankle & foot soft tissue defect.

Combination of OCT and FFA for the research of pathogenesis of central serous chorioretinopathy / 中华实验眼科杂志

Background The diagnosis of central serous chorioretinopathy (CSC) is mainly dependent onfluorescine fundus angiography (FFA). However, the combination of optical coherence topography (OCT) with FFA offers a new approach to the research of the pathogenesis of CSC. Objective This clinical study was designed to study the combined application of the FFA and OCT for the research of the pathogenesis of central serous chorioretinopathy (CSC). Methods Forty-four eyes of 44 patients with CSC were included in this study with 36 cases of males and 8 cases of female. The patients were aged 39.3 ± 5.3 years and the visual acuity was 0. 64 ±0. 27. FFA and OCT examinations were performed in all patients and the FFA images were imported into the Topcon 3D OCT 1000 device to locate the conformity of OCT lesions with the leakages of FFA. The neuroepithelial layer thickness at the fovea and the height of the neuroepithelial layer detachment were measured using 3-D OCT. Results OCT showed serous REP detachment in 34 eyes (77.3%) and rough surfaces of RPE in 10 eyes (22. 7% ). In thirtyfour eyes with RPE detachment, the OCT lesions and FFA leakage spots conformed to the same locations in 31 eyes, but the other three eyes did not. The mean foveal neuroepithelial thickness was (138.5±19.4) μm in CSC eyes and that of normal eyes was ( 131.35±5. 01 ) μm ,showing a significant difference between them( t=0. 39 ,P＞0. 05 ). The mean height of neuroepithelial detachment was (263.3 ± 126.7 ) μm in CSC eyes. Conclusion RPE detachment occurs in CSC eyes and further induces macular neuroepithelial detachment. Leakage lesion of fluorescine corresponds to RPE detachment. CSC without RPE detachment may be related to the increase in RPE permeability. OCT can accurately measure the thickness of the macular neuroepithelial layer and the height of the neuroepithelial detachment.

Repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint (DIP).</p><p><b>METHODS</b>From Jun. 2009 to Mar. 2010, 15 cases with soft tissue defects at 15 fingers tip were treated with this island flaps. The flap size ranged from 1.2 cm x 0.8 cm to 2. 0 cm x 3.0 cm. The defects at donor sites were covered with skin grafts from forearm.</p><p><b>RESULTS</b>All the flaps and skin grafts survived. 10 fingers in 10 cases were followed up for 6-12 months. The color, texture and contour of the flaps were good. The two-point discrimination distance was 5-6 mm on the directed island flaps, and 7-10 mm on the reverse island flaps. No obvious functional problem was found in DIP motion. The hand function was assessed as excellent in 8 fingers, good in 1 finger and medium in 1 finger.</p><p><b>CONCLUSIONS</b>The main artery and nerve will not be sacrificed when the island flap is used. The operative procedures are easily performed for the treatment of fingertip skin defect.</p>

Application of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot.</p><p><b>METHODS</b>From Aug. 2008 to Aug. 2010, 9 cases with skin defects at the dorsal side of feet were treated by V-Y flaps pedicled with superior malleolus cutaneous branch. The flap size ranged from 6.0 cm x 5.5 cm to 12.0 cm x 6.5 cm. The defects at the donor sites were closed directly.</p><p><b>RESULTS</b>All flaps survived completely. 9 cases were followed up for 6-12 months after operation. The flaps had good texture and color match. The 2-point discrimination distance at the flap was 10-14 mm. The function of ankle was normal.</p><p><b>CONCLUSIONS</b>The V-Y flap pedicled with superior malleolus cutaneous branch is ideal for the treatment of small skin defect at the dorsal side of foot.</p>

Effect of age on pharmacodynamics of cisatracurium target-controlled infusion / 临床麻醉学杂志

Objective To evaluate the effect of age on pharmacodynamics of eisatracurium target-controlled infusion(TCI). Methods Forty patients under N_2O-O_2-propofol-fentanyl anesthesia were divided into groups of Ⅰ and Ⅱ with 20 cases each. Under TOF stimulation monitoring, eisatracurium 0. 15 mg/kg was injected and tracheal intubation was performed when TOFr being zero. and the intubation conditions were evaluated. When T1 restored to 50% cisatracurium TCI started to keep TOFr less than 10%. The recovery times of neuromuscular blockade were recorded after stopping infusion. The amount of cisatracurium consumption was calculated. Results Intubation conditions the onset time and recovery index were not significantly different between two groups. The nonresponse period, duration of action, and recovery time were longer in group Ⅰ than those in group B. Cisatracurium consumption was more in group Ⅰ than that in group Ⅱ (P<0.05). Conclusion By TCI,cisatracurium dosage needed for keeping TOFr less than 10% is less,but the recovery process is still longer in the elderly than those in the younger.

Repair of thumb tip defect with thumb island flaps at ulnar side by V-Y advancement / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the method for treatment of thumb tip defect.</p><p><b>METHODS</b>The thumb tip defect was treated with thumb island flaps at ulnar side by V-Y advancement. The flap size ranged from 1.4 cm x 2.0 cm approximately 1.4 cmx 2.5 cm. The wounds at donor sites were covered by skin grafts.</p><p><b>RESULTS</b>From March 2007 to October 2009, 10 cases of thumb tip defects were treated. All the flaps and skin grafts were survived with primary healing. The patients were followed up for 6-18 months with both satisfactory functional and cosmetic results. The two-point discrimination was 5-6 mm at the thumb tip.</p><p><b>CONCLUSIONS</b>The thumb tip defect can be successfully repaired with thumb island flaps at ulnar side by V-Y advancement.</p>

Effects of LMA and intubation on the level of catecholamine in elderly patients with cororay heart disease / 中国基层医药

Objective to compare the LMA and intubation in elderly patients with coronary heart disease hemedynamics,respiratory function and the impact of stress hormones.Methods 32 cases of elderly patients with coronary heart disease ASA II level under general anesthesia in the implementation of gastrointestinal surgery,were randomly divided into LMA group and endotracheal intubation group.Before the induction of anesthesia (T0),insert the LMA/endotracbeal tube before(T1),insert the LMA/tracheal tube immediately after(T2),insert the LMA/endotracbeal tube after 5 min(T3) ,10 min(T4),15 min(T5) and the skin incision,(T6) ,immediately after extubation (T7) record SBP,DBP,HR.Application BICORE monitor respiratory function 16 indicators,select T0,T3,T4,T5,T7 record at the suction tidal volume (,VTI),breath tidal volume (VTE),minute ventilation (VE),Inspiratory peak velocity(PIFR),peak expiratory flow rate (PEFR) ,peak inspiratory pressure(PIP) and the average airway resistance (RAWM).Patients in each group T0,T1,T2,T6,T7 at the application of high performance Iiqnid chromatography analysis of plasma epinephrine(AE),norepinephrine(NE),dopamine (DA) level.Results intubation group T2 at the SBP,DBP,HR significantly higher than the LMA group (P＜0.05) ;,VTI,VTE,VE,PIFR,PEFR,PIP and RAWM group there was no significant difference,AE,NE,DA in T2,T7,were significantly higher than the LMA group (P＜0.05).Conclusion Laryngeal Mask Airway general anesthesia for elderly patients with coronary heart disease is better than intubation,easy to maintain stable bemedynamics,the stress response minor,after the restoration of a smooth general anesthesia.

Reconstruction of many fingers with bilateral multiple toe transplantation / 中华显微外科杂志

@#Objective To evaluate the treatment effect of hand reconstruction with bilateral multiple toe transplantation. Methods There are four schedules as follow applied in 102 cases: (1) bilateral second toes to thumb and index finger transplantation in 86 cases; (2) wrap-around flap to thumb and second toe on opposite side to index or middle finger transplantation in 11 cases; (3) wrap-around flap to thumb and bilateral second toes to index and middle fingers transplantation in 8 cases; (4) bilateral wrap-around flap to bilateral thumb and second toe to index finger transplantation in 1 case. Results All reconstructed finger survived in 102 cases except for partial wrap-around flap necrosis in one case and second toe in two cases. Sixty-two patients got more than one-year following up. Two points discrimination in reconstructed finger was between 8 to 14 mm in all cases. The reconstructed finger grew synchronously with toe among children. Thumb opposition function recovered in all cases except for one case. Donor site: no limp or hallux eversion observed in all cases. Conclusion There is less damage on foot and most hand function recovery using bilateral multiple toe transplantation to repair hand or multiple fingers defect.

Study on the safety and immunogenicity of group A + C meningococcal polysaccharide vaccine / 中华流行病学杂志

<p><b>OBJECTIVE</b>In order to evaluate the safety and immunogenicity of group A + C meningococcal polysaccharide vaccine, a controlled field trial was performed among children at 6-24 months and 5-13 years old in Longsheng county, Guangxi Zhuang Autonomous Region.</p><p><b>METHODS</b>More than 600 children were selected in this trial. 428 children, aged 6-24 month-old and 5-13 year-old were involved in two experimental groups and were inoculated 100 microg of group A + C meningococcal polysaccharide vaccine. 103 children in positive control group were inoculated 50 microg of group A meningococcal polysaccharide vaccine while 94 children in negative control group were inoculated 30 microg of Typhoid Vi polysaccharide vaccine. Both systemic and local reactions were observed in each group at 6 h,24 h,48 h and 72 h after inoculation. Blood samples were collected in all children before and at 1 month after inoculation. Additionally, at least 50 blood samples were taken in each experimental group at 6 and 12 months after inoculation. Serum bactericidal antibody was tested by micro bactericidal test.</p><p><b>RESULTS</b>Both systemic and local reactions were mild in two experimental groups with only 3 children (0.7%) had > or = 37. 6 degrees C fever, 4 children (0.9%) appeared mild areola but all adverse reaction disappeared within 48 hours. In 5-13 year-old experimental group, the rates for four-fold increase of bactericidal antibody were 96.59% and 92.15% to group A and group C meningococcus respectively at 1 month after inoculation, and remained 90.91% and 90.08% at 12 months after inoculation.</p><p><b>CONCLUSION</b>Group A + C meningococal polysaccharide vaccine was safe and having good immunogenicity among Chinese children.</p>