3D reconstruction assisted preoperative optimal design of anterolateral abdomen cross-region free perforator flap for repair of soft tissue defects in limbs / 中华显微外科杂志

Objective:To investigate the clinical effect of a 3D reconstruction assisted preoperative optimal design of anterolateral abdomen cross-region free perforator flaps for repair of soft tissue defects of limbs.Methods:Twenty patients who were treated for soft tissue defects of hand, forearm, foot and ankle in the Department of Hand Surgery, the Sixth Hospital of Ningbo from October 2017 to January 2020 were included in this study. Among the patients,17 had soft tissue defects in hand and forearm and 3 with composite tissue defects including ankle and soft tissue defect of foot. The sizes of soft tissue defects in limbs ranged from 6 cm × 8 cm - 36 cm × 18 cm. Twenty free cross-area perforator flaps were optimal designed with CTA and 3D assisted reconstruction before surgery. Following combinations of flaps were designed: (1) Free perforator flap with inferior abdominal artery and superior abdominal artery; (2) Free perforator flap with superficial iliac circumflex artery and deep iliac circumflex artery; (3) Free perforator flap with superficial iliac circumflex artery and inferior abdominal wall perforator artery; (4) Free perforator flap with perforators of superficial iliac circumflex artery plus superficial abdominal artery; (5) Free perforator flap with perforating artery of lower abdominal wall and superficial artery of abdominal wall. The overall nutritional area of a combined flap were 272.3 cm 2± 12.5 cm 2, 107.4 cm 2± 9.3 cm 2, 193.6 cm 2± 24.2 cm 2, 155.2 cm 2± 20.1 cm 2 and 203.7 cm 2± 16.3 cm 2, respectively. All the donor sites were sutured directly in one stage. The appearance, texture, blood supply, colour, joint movement of affected limbs, recovery and function of donor sites were observed through postoperative follow-up visits at the outpatient clinic. Results:Among the 20 anterolateral transventral perforator flaps, 18 flaps survived successfully; One had partial necrosis after surgery, and healed after dressing change. Subcutaneous haematoma occurred in 1 flap, and survived after drainage. In this study, there was no postoperative infection of flap. A total of 19 flaps healed in one stage, except 1 that had a delayed healing and the flap wound was closed after dressing change for 1 week. According to Disability of Arm, Shouder and Hand (DASH) questionnaire evaluation, which is widely used in the world to evaluate the therapeutic effect after limb injury, combined with the 6-12 months of follow-up, the functional recovery of 17 patients with upper limbs iniury was 7 in excellent, 9 in good and 1 in poor. The overall excellent and good rate achieved 94.1%. All the 3 patients with foot injury recovered well, and the walking and jumping were not significantly affected. The results were all excellent according to the Maryland Foot Function Scoring. Sensation of flaps was evaluated according to the British Sensory Function Evaluation, it showed: 3 in S 2, 15 in S 3 and 2 in S 3+. All 20 flaps had good blood supply, in soft texture, good colour, feeling, thickness and movement. The donor sites all healed well. Conclusion:Combined with an optimal preoperative design, the perforator flap of anterior lateral wall cross-region can obtain a satisfactory clinical efficacy in repair of large area soft tissue defects. It is a feasible treatment method.

Developing biosecurity training program under the background of new engineering education in colleges and universities / 生物工程学报

The global biosecurity situation has become increasingly severe in recent years. The threats from outbreaks of epidemics, misuse and abuse of biotechnology, biological weapons and so on are emerging, which make biosecurity an important part of national security. Meanwhile, as a new interdisciplinary program, the education for biosecurity is still in its infancy. The challenges of domestic and international biosecurity and the quick development of biosecurity industry necessitate the establishment of security disciplines, which expose the deficiencies of talent pool in the interdisciplinary field involving biosecurity in China. Especially under the background of new engineering education, the importance of biosecurity training program has become more obvious than before. On the basis of our teaching experience, we systemically introduced the specific measures to improve the training system of biosecurity in the context of new engineering education, such as establishing an integrated curriculum system, constructing innovative teaching modes, exploring general education reform plans, and perfecting continuous improvement mechanisms.

Using OMICS technologies to analyze the mechanisms of synthetic microbial co-culture systems: a review / 生物工程学报

In recent years, the interaction mechanisms underpinning the synthetic microbial co-culture systems have gained increasing attention due to their potentials in various biotechnological applications. Exploration of the inter-species mechanisms underpinning the synthetic microbial co-culture system could contribute to a better understanding of the theoretical basis to further optimize the existing co-culture systems, and design new synthetic co-culture system for large-scale application. OMICS technologies such as genomics, transcriptomics, proteomics, and metabolomics could analyze the biological processes in a high throughput manner. Multi-omics analysis could achieve a "global view" of various members in the microbial co-culture systems, which presents opportunities in understanding synthetic microbial consortia better. This article summarizes recent advances in understanding the mechanisms of synthetic microbial co-culture systems using omics technologies, from the aspects of metabolic network, energy metabolism, signal transduction, membrane transport, stress response, community stability and structural rationality. All these findings could provide important theoretical basis for future application of the microbial co-culture systems with the aids of emerging biotechnologies such as synthetic biology and genome editing.

Recent progress in photosynthetic microbial co-culture systems / 生物工程学报

Co-culture systems consisted of photosynthetic microorganisms and others heterotrophic microbes have attracted great attention in recent years. These systems show many advantages when compared with single culture grown under autotrophic conditions, such as less vulnerable to pollution and more stability, thus have been applied to wastewater treatment, soil remediation, biodegradable harmful substances, and production of high value-added products. In order to explore basic theory and further applications, we summarize here recent progresses in artificial co-culture systems of using photosynthetic microorganisms, to provide a current scientific understanding for the rational design of the co-culture system based on photosynthetic microorganisms using synthetic biology.

Application of hemi excision of trapezium combined with tendon ball tamponade in the treatment of first carpometacarpal arthritis / 中华骨科杂志

Objective:To describe the treatment of the first carpometacarpal arthritis in Eaton Ⅱ, Ⅲ combining the hemi excision of trapezium with tendon ball and evaluate its clinical efficacy.Methods:Data of patients with the first carpometacarpal arthritis who were treated by hemi excision of trapezium and tamponade of the tendon ball from March 2013 to October 2018 were retrospectively analyzed. Twelve patients were all females with an average age of 55±2.8 years (range, 48-61 years). There were 3 cases of left thumbs and 9 cases of right. The study was only researched with primary osteoarthritis patients, preoperative imaging Eaton stages, including 8 cases inⅡstage, 4 cases in Ⅲ stage. Postoperative X-ray examination was performed, and the subsidence rate of the first metacarpal bone was evaluated according to height of arthroplasty. Preoperative and postoperative pain was evaluated according to visual analogue scales (VAS) score and DASH score. Preoperative and postoperative finger movement was evaluated according to the changes in preoperative and postoperative grip and pinch force.Results:The average follow-up period was 12±4.8 months (range, 6-17 months). The mean score of VAS after operation was 1.2±1.0 which was lower than 6.3±1.5 before operation ( t=13.4, P=0.0001); DASH score after operation was 26.2±9.6 which was lower than 48.9±13.0 before operation ( t=5.7, P=0.0001); Grip force after operation was 25.5±6.8 kg which was higher than 15.0±2.9 kg before operation ( t=7.3, P=0.0001); Pinch force after operation was 3.2±0.8 kg which was higher than 2.1±0.4 kg before operation ( t=3.6, P=0.0045), and all of these four above data has statistic difference. At the latest postoperative follow-up, the height index of arthroplasty was 0.299±0.022, and there was no significant change ( F=1.337, P=0.276) when compared with 0.306±0.021 before surgery and 0.313±0.024 after surgery. After the operation, 2 patients presented with incision redness and swelling and exudation. It was considered that local hematoma in the intra-articular operation could not be completely absorbed. After several dressing changes, the redness and swelling subsided and the exudation was controlled. Conclusion:Preserving the proximal joint surface of trapezium and tamponading tendon ball, could reduce the subsidence rate of the first metacarpal bone and alleviate the pain of the first carpometacarpal joint, thus may effectively improve the joint function. It has a significant effect on the treatment of Eaton Ⅱ,Ⅲ stage of the first carpometacarpal arthritis.

Light and carbon dioxide-driven synthesis of high-density fuel in Synechococcus elongates UTEX 2973 / 生物工程学报

Development of "liquid sunshine" could be a key technology to deal with the issue of fossil fuel depletion. β-caryophyllene is a terpene compound with high energy density and has attracted attention for its potential application as a jet fuel. The high temperature and high light-tolerant photosynthetic cyanobacterium Synechococcus elongatus UTEX 2973 (hereafter Synechococcus 2973), whose doubling time is as short as 1.5 h, has great potential for synthesizing β-caryophyllene using sunlight and CO₂. In this study, a production of ~121.22 μg/L β-caryophyllene was achieved at 96 h via a combined strategy of pathway construction, key enzyme optimization and precursor supply enhancement. In addition, a final production of ~212.37 μg/L at 96 h was realized in a high-density cultivation. To our knowledge, this is the highest production reported for β-caryophyllene using cyanobacterial chassis and our study provide important basis for high-density fuel synthesis in cyanobacteria.

Microsurgical anatomy and clinical application of thoracodorsal artery perforator flap / 中华显微外科杂志

Objective:To investigate the microsurgical anatomy of thoracodorsal artery perforators, and the clinical effect in repairing the soft tissue defect of hand with the thoracodorsal artery perforator flap (TAP).Methods:From October, 2014 to November, 2014, the axillary arteries in 10 thoracodorsal specimens were perfused with red latex. The number and diameter of the perforators of the thoracodorsal arteries were mearsured. From January, 2015 to February, 2019, 52 cases of soft tissue defects in hand combined with bone and extensor tendon exposure were repaired with TAP. The patients were followed-up in outpatient department to observe the clinical efficacy.Results:The number of perforators of thoracodorsal artery was 2-4 mostly, and 3 perforators was the most. The diameter of perforators was 0.22-0.68 mm, and the distance between the perforating point and the posterior axillary wall was 5.2-11.8 cm. All the operations were completed successfully, and the donor sites were closed directly. In 52 cases, 48 flaps survived, 2 had partially necrosis, and 2 had completely necrosis. The patients were followed-up for 5 to 24 months. The blood supply of the flaps was good with soft texture and good appearance.Conclusion:The TAP is an ideal flap because of its thin in thickness, concealed donor area and no obvious scar after direct suture.

The application of turbocharging technique in repairing large defect with free perforator flap / 中华整形外科杂志

Objective@#To investigate the feasibility and clinic outcome of the turbocharging technique in repairing large defect with free perforator flap.@*Methods@#From January 2017 to December 2018, 6 patients with defect of over length or large size were repaired with free perforator flaps, anterolateral thigh(ALT) flap in 3 cases and deep inferior epigastric artery perforator(DIEP) flap in 3 cases in Department of Hand Surgery, Ningbo No.6 Hospital. There were 4 males and 2 females, aged from 29 to 54 years old, with an average age of 41 years old.It was found that the size of the flap beyond the perforasome, while multiple perforators in the flaps were not from the same pedicle. The turbocharging technique was applied in the operation. The distal perforator of the flap was anastomosed with the proximal pedicle branch. The flap size ranged from 20 cm×8 cm to 25 cm×12 cm. The donor sites were closed directly for 3 cases and skin grafting for 3 cases.@*Results@#All the flaps survived successfully, no distal necrosis occurred. The patients were followed up for 3 to 12 months, with an average of 9 months. All flaps survived well with satisfactory appearance and pliable texture. The healing of skin graft was satisfactory in 3 cases in donor site. No graft skin contracture occurred. The donor sites closed directly in 3 cases had linear scar in donor site, no obvious contracture occurred. The flap sensation returned to S2-S3.@*Conclusions@#If the size of the flap is super long or large, beyond the perforasome, while multiple perforators in the flaps were not from the same pedicle, the application of turbocharging technique can avoid partial necrosis of the flap and improve the survival rate of the flap, which is an ideal alternative.

Significance of changes of difference in percutaneous-arterial blood partial pressure of carbon dioxide in liquid resuscitation of patients with septic shock / 中国中西医结合急救杂志

Objective To approach the significance of changes of percutaneous-arterial blood carbon dioxide partial pressure difference [P(tc-a)CO2] in liquid resuscitation of patients with septic shock. Methods One hundred and sixty-eight patients with septic shock admitted and treated in the Department of Intensive Care Unit (ICU) of Quzhou People's Hospital from January 2015 to January 2018 were enrolled, and after early goal-directed therapy (EGDT) for 6 hours, according to central venous oxygen saturation (ScvO2) and lactate clearance (LC), they were divided into ScvO2 and LC achievement group (ScvO2 ≥ 0.7 and LC≥10%), ScvO2 achievement group (ScvO2 ≥ 0.7 and LC < 10%), LC achievement group (ScvO2 < 0.7 and LC≥10%), and un-achievement group (ScvO2 < 0.7 and LC < 10%). The mechanical ventilation time, ICU hospitalization time, 28-day mortality, P(tc-a)CO2 etc. were compared among the four groups; the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of P(tc-a)CO2 for 28-day prognosis in patients with septic shock. Results The trends of mechanical ventilation time, ICU hospitalization time, and 28-day mortality were all ScvO2 and LC achievement group < LC achievement group < ScvO2 achievement group < un-achievement group [the mechanical ventilation times (days) were respectively 6.12±2.59, 8.43±3.24, 11.78±4.12, 13.03±4.75, ICU hospitalization times (days) were 10.31±2.32, 13.85±3.56, 16.41±3.83, 18.52±4.05, and 28-day mortality rates were 28.85% (15/52), 40.91% (18/44), 51.28% (20/39), 69.70% (23/33)] and the differences among the four groups were statistically significant (all P < 0.05). After 6 hours of EGDT, the heart rate (HR), lactate (Lac), and P(tc-a)CO2 were lower than those before fluid resuscitation, but the mean arterial pressure (MAP), central venous pressure (CVP), and ScvO2 were higher than those before fluid resuscitation among four groups. Except CVP, the differences of other indicators compared among the ScvO2 and LC achievement group, ScvO2 achievement group, LC achievement group and un-achievement group were statistically significant (all P < 0.05). After 6 hours of EGDT, HR, Lac, P(tc-a)CO2 in ScvO2 and LC achievement group, ScvO2 achievement group and LC achievement group were significantly lower than those in the un-achievement group [HR (bpm): 89.05±29.43, 98.82±30.21, 94.33±28.64 vs. 112.85±32.74, Lac (mmol/L): 2.97±1.95, 3.87±2.32, 2.69±1.52 vs. 4.17±2.44, P(tc-a)CO2 (mmHg, 1 mmHg = 0133 kPa): 7.18±4.61, 12.61±5.34, 9.71±4.11 vs. 16.56±10.19], MAP and ScvO2 were significantly higher than those of the un-achievement group [MAP (mmHg): 88.05±21.67, 77.33±18.56, 83.11±19.71 vs. 70.32±18.79, ScvO2: 0.76±0.14, 0.75±0.16, 0.67±0.14 vs. 0.63±0.18, all P < 0.05]. The P(tc-a)CO2 of 28 days survivors were significantly lower than that of the deaths among four groups (mmHg: 5.78±2.27 vs. 14.14±3.65, 7.07±2.81 vs. 15.06±4.11, 6.35±2.09 vs. 14.94±4.06, 7.93±3.81 vs. 18.34±4.63, all P < 0.05). When P(tc-a)CO2 > 7.24 mmHg predicted 28-day mortality in ScvO2 and LC achievement group, the sensitivity was 89.29%, specificity was 91.45%, and the area under ROC curve (AUC) was 0.86; when P(tc-a)CO2 > 9.46 mmHg predicted 28-day mortality in LC achievement group, the sensitivity was 88.72%, specificity was 85.83% and AUC was 0.91; when P(tc-a)CO2 >12.05 mmHg predicted 28-day mortality in ScvO2 achievement group, the sensitivity was 82.79%, specificity was 86.90% and AUC was 0.79; when P(tc-a)CO2 > 16.22 mmHg predicted 28-day mortality in un-achievement group, the sensitivity was 73.35%, specificity was 80.68% and AUC was 0.68. Conclusion P(tc-a)CO2 can be used as an indicator to evaluate fluid resuscitation effect and prognosis in patients with septic shock.

The effect of enteral immune nutrition on occurrence of acute kidney injury in patients with sepsis / 中国中西医结合急救杂志

Objective To evaluate the effect of enteral immune nutrition on the occurrence of acute kidney injury(AKI) in sepsis patients. Methods A retrospective study was conducted, 80 patients with sepsis admitted and treated in the intensive care unit (ICU) of Quzhou People's Hospital from January 2015 to December 2016 were enrolled, and according to different treatment programs, they were divided into an immune nutrition group and a standard nutrition group, each group 40 cases. The two groups received an equal amount of calories and nitrogen in enteral nutrition (EN). After treatment, the changes of serum total protein (TP), albumin (Alb), prealbumin (PA), hemoglobin (Hb), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin (IL-6, IL-10), infection site, length of stay in ICU, mortality in ICU, AKI incidence, AKI staging, etc in the two groups were observed. Results ① After treatment, the nutritional indicators TP, Alb, PA, Hb levels were significantly increased, the serum inflammatory factors CRP, TNF-α, IL-6 were obviously decreased and IL-10 was markedly increased in the two groups compared with those before treatment (all P < 0.05), the changes in the immune nutrition group were more obvious than those in the standard nutrition group [TP (g/L): 60.84±5.90 vs. 58.32±6.11, Alb (g/L): 33.95±3.83 vs. 31.79±3.44, PA (g/L): 0.24±0.04 vs. 0.21±0.03, Hb (g/L): 117.47±16.15 vs. 112.50±15.71, CRP (mg/L): 53.04±23.76 vs. 82.33±37.09, TNF-α (ng/L): 20.29±17.74 vs. 29.63±18.43, IL-6 (ng/L): 50.74±28.55 vs. 80.32±31.67, IL-10 (ng/L): 41.09±24.65 vs. 40.86±24.73]; ② The length of stay in ICU (days: 10.54±4.33 vs. 14.80±5.19), ICU mortality [15.00% (6/40) vs. 32.50% (13/40)] and the incidence of AKI [22.50% (9/40) vs. 47.50% (19/40)] of immune nutrition group were significantly lower than those of standard nutrition group (all P < 0.05); There were 9 cases of AKI mainly at stage I andⅡ (8 cases) in the immune nutrition group, while in the standard nutrition group there were 19 cases with AKI mainly at stageⅢ (11 cases). Conclusion The enteral immune nutrition can effectively reduce the incidence of AKI in sepsis patients, and the mechanism may be related to the immune nutritional preparation can inhibit the expressions of pro-inflammatory factors such as TNF-α, IL-6, etc.

Evaluation of group B Streptococcus (GBS) screening in late pregnancy and intrapartum antibiotic prophylaxis for prevention of neonatal early-onset GBS disease / 中华围产医学杂志

Objective To study the colonization rate and antibiotic resistance of group B Streptococcus (GBS) in gravidas during late pregnancy,and to evaluate the effectiveness of GBS screening in late pregnancy and intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal early-onset GBS disease (EOGBS).Methods A retrospective study was conducted to analyze the colonization rate and antibiotic resistance pattern of GBS in 14 204 gravidas who were screened for GBS at 35-37 gestational weeks during March 2016 to March 2018 in the University of Hongkong-Shenzhen Hospital (HKU-SZH).Differences in the incidence of EOGBS before and after GBS screening and IAP were analyzed using Chi-square or Fisher's exact test.Results Among the 14 204 gravidas,2 027 cases were GBS positive with a colonization rate of 14.27％.Incidence rates of EOGBS before and after GBS screening were 0.6‰ (4/6 356) and 0.07‰ (1/14 403),respectively (Fisher's exact test,P=0.033).GBS isolates were 100％ (2 027/2 027) sensitive to penicillin and vancomycin.Resistance rates to clindamycin and erythromycin were 67.2％(1 363/2 027) and 65.7％ (1 332/2 027),respectively.Conclusions Routine GBS screening in late pregnancy and IAP can significantly decrease the incidence of EOGBS.Penicillin is the optimal choice for prevention and treatment of GBS infection.

Effects of glucocorticoids on intracellular calcium in microglial cells / 中国药理学通报

Aim To explore the effects of hydrocortisone on intracellular calcium in microglial cells.Methods The intracellular calcium was measured by instantaneous scanning with confocal laser microscope(CLM) in BV-2 cells, and fluo3-AM was used to dye the intracellular calcium.Results Both hydrocortisone and nicotine could obviously increase intracellular calcium in BV-2 cells(P0.05);but the blocker of α7 nicotinic acetylcholine receptor(α7nAChR) methyllycaconitine could suppress the rising of intracellular calcium induced by hydrocortisone(P<0.05).Conclusion Hydrocortisone enhances intracellular calcium via α7nAChR in microglial cells, which not only demonstrates the non-genomic effect of glucocorticoid, but also suggests that glucocorticoid could serve as endogenous ligand of α7nAChR.

Determination of Five Index Components in Yinzhihuang Oral Liquid by Quantitative Analysis of Multi-components by Single Marker / 中国药师

Objective:To develop a method of quantitative analysis of multi-components by single marker ( QAMS) for five index components in Yinzhihuang oral liquid. Methods:Using baicalin as the reference,an HPLC method with a Venusil MP C18 (2) column (250 mm × 4. 6 mm,5 μm) was applied,the mobile phase was acetonitrile-0. 1% phosphoric acid with gradient elution,the flow rate was 1. 0 ml·min-1 ,the detection wavelength was 327 nm, the column temperature was 35℃ and the injection volume was 10μl. The relative correction factors among the five index components were detected by QAMS. The five index contents were determined respec-tively by an external standard method and QAMS, and the results obtained from the two different methods were compared to verify the practicability and stability of QAMS. Results: The established QAMS method was used to determine the five index components in 6 batches of Yinzhihuang oral liquid. There were no significant differences in the calculated values and the determined ones (P>0. 05). Conclusion:The QAMS method is simple,effective and accurate in determining the contents of five index components in Yinzhihuang oral liquid,which can be used for the quality control of Yinzhihuang oral liquid and provide reference for the further studies.

Determination of Five Index Components in Yinzhihuang Oral Liquid by Quantitative Analysis of Multi-components by Single Marker / 中国药师

Objective:To develop a method of quantitative analysis of multi-components by single marker ( QAMS) for five index components in Yinzhihuang oral liquid. Methods:Using baicalin as the reference,an HPLC method with a Venusil MP C18 (2) column (250 mm × 4. 6 mm,5 μm) was applied,the mobile phase was acetonitrile-0. 1% phosphoric acid with gradient elution,the flow rate was 1. 0 ml·min-1 ,the detection wavelength was 327 nm, the column temperature was 35℃ and the injection volume was 10μl. The relative correction factors among the five index components were detected by QAMS. The five index contents were determined respec-tively by an external standard method and QAMS, and the results obtained from the two different methods were compared to verify the practicability and stability of QAMS. Results: The established QAMS method was used to determine the five index components in 6 batches of Yinzhihuang oral liquid. There were no significant differences in the calculated values and the determined ones (P>0. 05). Conclusion:The QAMS method is simple,effective and accurate in determining the contents of five index components in Yinzhihuang oral liquid,which can be used for the quality control of Yinzhihuang oral liquid and provide reference for the further studies.

Comparison of end-to-side and end-to-end microvascular anastomosis in free perforator flap transfer for hand skin and soft tissue defect / 中华显微外科杂志

Objective To observe the survival rate of free flaps and incidence of vascular crisis following the perforator flap transfer in end-to-side microvascular anastomosis compared with the traditional method and investigate the scientificity and practicability of this scheme.Methods From February, 2012 to October, 2013, 152 cases of free flaps (including superficial illiac circumflex perforator flap, lateral arm flap, peroneal perforator flap, and anterolateral thigh flap) were performed.The end-to-side anastomosis were performed in 72 cases while end-to-end anastomosis in 80 cases;All patients were followed up for 6-24 months.The occurrence of vascular crisis in all cases were observed and recorded.The results of the two groups were conducted statistical analyzed.Results The average anastomosis time for end-to-side anastomosis (21.3 ± 3.8 min) was significantly higher than the end-to-end anastomosis (14.4 ± 3.2 min) (P ＜ 0.05).The incidence of anastomotic vasospasm after end-to-side anastomosis (5.6％) was significantly lower than traditional method (16.3％) (P ＜ 0.05).There was no significant difference in the survival rate of the free flaps between the end-to-side anastomosis group (97.2％) and the traditional group postoperatively (96.3％) (P ＞ 0.05).Conclusion Although anastomosis times were increased in the end-to-side group, this technique showed lower spasm rate and similar flap survival rate.Therefore, this technique is a reliable and technically feasible method and should be considered first as a choice when facing vessel discrepancy and for preserving the recipient artery and vein system.

Early interventional therapy for acute massive and submassive pulmonary embolism / 中华普通外科杂志

Objective To evaluate interventional therapy for acute massive and submassive pulmonary embolism.Methods From June 2011 to June 2014.53 patients were enrolled and divided into group massive pulmonary embolism (MPE,n =16) and group submassive pulmonary embolism (SPE,n =37),both receiving catheter thrombectomy + contact thrombolysis within 12 hours after diagnosis.Preand post-interventional measures were assessed,including mean pulmonary arterial pressure (MPAP),cardiac biomarkers,tricuspid regurgitation,right ventricular (RV) dilatation,and massive hemorrhage within 72 hours.Patients were followed up for 6 months for the occurrence of chronic thromboembolic pulmonary hypertension.Results In all 53 patients were successfully completed catheter thrombectomy +contact thrombolysis,the mean pulmonary artery pressure in group MPE decreased from (47 ± 6)mmHg to (34 ± 4) mmHg (P ＜ 0.05),and in group SPE decreased from (44.2 ± 1.5) mmHg to (31.4 ± 6.2) mmHg (P ＜ 0.05).The ventriculus dexter disfunction was alleviated in 78.4％ patient after therapy.Overall 1.9％ patients suffered from massive hemorrhage,(0) in group MPE,and (2.7％)in group SPE.The incidence of chronic thromboembolic pulmonary hypertension during 6 moths follow up was 0.Conclusion Early interventional therapy for massive and submassive pulmonary embolism decreased pulmonary artery pressure,relieved right ventricular dysfunction,reduced bleeding complications and the incidence of chronic thromboembolic pulmonary hypertension.

Invasive hemodynamic monitoring guided early interventional treatment of acute massive pulmonary embolism / 中华普通外科杂志

Objective To investigate the clinical significance of invasive hemodynamic monitoring in early interventional treatment of acute massive pulmonary embolism.Methods From 2010 June to 2014 January,40 cases of acute massive pulmonary embolism admitted to the ICU in our hospital were analyzed divided into experimental group (20 cases) and control group (20 cases):while receiving conventional dose of peripheral venous thrombolytic therapy,the therapeutic effect of thrombolysis was evaluated by different ways.In experimental group,adopted Vigileo technology for continuous monitoring SVV,CI and ScvO2,guiding thrombolytic and interventional therapy after 12 hrs.If after 24 hrs the right ventricular ejection fraction (RVEF) and pulmonary artery systolic pressure (PSAP) did not improve,patients were converted to interventional therapy.We compared the CVP,MAP,PO2/FIO2,RVEF,PSAP,28-day mortality and the change in pulmonary vascular after 6 month.Result In two groups,CVP,MAP,PO2/FIO2 improved similarly after thrombolytic therapy.The experimental group were under the continuous monitoring of hemodynamic,12 patients were shifted to interventional therapy when ScvO2,SVV,CI did not increase after 12 hours.While 4 patients in control group were converted to interventional therapy after 24 hours.In the experimental group after 24 hours thrombolytic,the PO2/FIO2,RVEF and PSAP were higher than those in the control group.Compared with the control group,28-day mortality were same,but after follow up six moths RVEF,PSAP significantly improved.Conclusions FloTrac/Vigileo monitoring technology can be applied in assessment of massive pulmonary embolism thrombolytic to guide early interventional therapy,improve the oxygenation and right heart failure in the early stage,reduce the occurrence of pulmonary hypertension,improve the long-term pulmonary function.

Optimization and application of targeted LC-MS metabolomic analyses in photosynthetic cyanobacteria / 生物工程学报

To accurately analyze metabolites in industry-important photosynthetic microbes, LC-MS based metabolomics protocol needs to be optimized specifically for individual species. In this study, an LC-MS based metabolomics method was optimized for cyanobacterium Synechocystis sp. PCC 6803. With the optimized extraction, liquid chromatographic and mass spectral parameters, the method was capable of detecting 24 important metabolites related to central carbohydrate and energy metabolism in Synechocystis sp. PCC 6803. The study laid an important foundation for the metabolomics analysis of cyanobacteria.

Identification and characterization of partner proteins interacting with fatty acid activation enzyme Slr1609 in Synechocystis sp. PCC 6803 / 生物工程学报

To understand molecular modules related to polyunsaturated fatty acids (PUFA) synthesis and eventually produce PUFA at high efficiency, we developed a protein complex analysis technology in Synechocystis sp. PCC 6803, and applied it to identify possible partner proteins interacting with the key enzymes that catalyze PUFA biosynthesis. We first constructed a recombinant expression of protein of slr1609 encoding the fatty acid activation enzyme, by fusing 3xFLAG tag with the target protein. Then we verified its expression by Western blotting targeting 3xFLAG tag. To maximize purification of Slr1609 protein complex, we optimized the protein expression conditions of Slr1609 in Synechocystis in a 5 L fermenter by monitoring its gene expression using RT-qPCR. The purification of the Slr1609 protein complexes was demonstrated by a Native-PAGE analysis. Finally, LC-MS/MS proteomic analysis allowed identification of the possible partner proteins interacting with Slr1609.

A method of reconstruction of type Ⅱ b defect of thumb both and reserving the length of the donor toe / 中华显微外科杂志

Objective To evaluate the clinical outcome of a method of renconstruction of Type Ⅱb defect of thumb both and reserving the length of the donor toe.Methods From March 2012 to Febrary 2014,there were 11 cases of thumb defect treated in our hospital.According to Gu Yudong's classification,all were type Ⅱ b.Three were open defect and others were closed defect.All were treated with combined transfer of big toe wrap-around flap and autogenous iliac graft for thumb reconstruction while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect.The donor site of the belly was sutured directly.Results All of the reconstructed thumb survived.Among 11 flaps,arterial crisis occurrred in 1 case,venous crisis occurred in 2 cases,and all survived after operative treatment.The patients were followed-up from 3 mooths to 15 months,all the thumbs had a good appearance.The thumb opposition function was good and sensation recovery to S3 + and two-point discrimination from 6-8 mm.The donor big-toe was preserved.All the flaps had satisfactory color and texture,but looked a little plump.All the patients had no effect on walking and running.Four flaps had more beautiful appearance after flap plastic.There was only one linear scar on the belly donor without any discomfort.Conclusion It is an effective method of combined transfer of big toe wrap-around flap and autogenous iliac graft while a superficial circumflex iliac artery perforator flap was used to resurface the donor defect used to reconstrucution of Type Ⅱ b defect of thumb is very good.