Free thin sensate superficial circumflex iliac artery perforator flap based on lateral cutaneous branch of the subcostal nerve for repair of soft tissue defect in the foot and ankle / 中华创伤杂志

Objective:To investigate the efficacy of free thin sensate superficial circumflex iliac artery perforator flap based on lateral cutaneous branch of the subcostal nerve for repair of soft tissue defect in the foot and ankle.Methods:A retrospective case series study was made on clinical data of 9 patients with soft tissue defect in the foot and ankle admitted to 80th Group Military Hospital from December 2017 to December 2019. There were 8 males and 1 females, with the age of 28-63 years [(47.3±12.3)years] and the body mass index (BMI) of 16.7-27.8 kg/m 2 [(23.9±3.9)kg/m 2]. The size of soft tissue defect ranged from 10 cm×6 cm to 20 cm×12 cm. All patients were treated with the free thin sensate superficial circumflex iliac artery perforator flap based on lateral cutaneous branch of the subcostal nerve. After debridement or tumor resection, a thin sensate flap was harvested by intra-adipose tissue dissection between the superficial and deep fat layers. The size of flap ranged from 13 cm×8 cm and 13 cm×10 cm. The thickness of the defatted flap ranged from 3-6 mm. The distance from the anterosuperior iliac spine to the point where the lateral cutaneous branch of the subcostal nerve crossed the iliac crest ranged from 7.5-10.0 cm. The flap survival, complications, and reoperation were observed after operation. The sensory recovery of the flap was evaluated using Tinel sign and nine-grid method including monofilament touch perception, vibration perception, pinprick perception, temperature perception, and static two-point discrimination test. The joint range of motion, and shoewear and walking problems were recorded. At the last follow-up, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to assess the affected foot and ankle. The injury at the donor site was detected as well. Results:All patients were followed up for 6-35 months [(21.1±10.1)months]. All flaps survived without infection or tumor reoccurrence. One patient developed ulceration, then surplus skin on the reconstructed heel was resected. One patient underwent flap debulking and removal of internal fixation. One or more sensory modalities within the nine areas in each flap could be detected at postoperative 3-6 months. The monofilament touch, vibration, pinprick, and temperature perception were presented in almost all regions of each flap at postoperative 12 months. However, only one patient in one region was noted with the static two-point discrimination, in which the distance of the two points was set as 25 mm. The range of ankle motion was slightly limited in 2 patients who underwent osseoligamentous complex reconstruction. All patients were able to wear normal shoes and walk without pain. At the last follow-up, the AOFAS ankle-hindfoot score ranged from 78 to 97 points [(86.4±7.4)points], significantly improved from preoperative 10-70 points [(44.2±18.4)points] ( P<0.01). No patients complained of pain at the donor site, but the widening linear scar was noted. Conclusion:For medium-sized soft tissue defect of the foot and ankle, the free thin sensate superficial circumflex iliac artery perforator flap based on lateral cutaneous branch of the subcostal nerve can be defatted with the requirement and has advantages in defect site appearance, sensory restoration, wearing ordinary shoes, painless walking, good functional recovery, and minimal donor site morbidity.

Clinical Effect of Modified Simiao San Compared and Colchicine in the Treatment of Damp Heat Gout / 现代生物医学进展

Objective:To compare the clinical effect and safety of modified Simiao San and colchicines on the damp heat gout.Methods:120 patients with damp heat gout admitted in our hospital in 2015 were selected and randomly divided into group A,group B and group C with 40 cases in each group.Patients in group A were given modified Simiao San,patients in group B were given colchicine,patients in group C were given modified Simiao San combined with colchicine.Then the clinical effect,scores of symptoms,expression levels of inflammatory factors and other biochemical indexes,adverse reactions and recurrence rate of 3 groups were compared berween three groups.Results:The total effective rate and effectually effective rate of group A were 92.5％ and 57.5％ respectively,which were 95.0％ and 65.0％ in group C was,obviously higher than 77.5％ and 35.0％ of group B (P＜0.05).The symptom scores of 3 groups after treatment were all lower than those before treatment (P＜0.05).The variety of ESR and UA of group C were greater than other groups (P＜0.05).The incidence rate of adverse reaction in group A and group C were 5.0％ and 7.5％ respectively,obviously lower than 22.5 of group B with statistically signficance (P＜0.05).The SF-36 score of group C was obviously lower than those of group A and group B with statistically significance (P＜0.05).Conclusion:Modified Simiao San combined with colchicine had better effect and safety compared to single medicine,which could greatly improve the quality of life.

Microscopic authentication method of traditional Chinese medicine Gusuibu / 中国中药杂志

<p><b>OBJECTIVE</b>To provide practical method for microscopic authentication of traditional Chinese medicine Gusuibu and its adulterants.</p><p><b>METHOD</b>By means of light microscope, scanning electron microscopy and tissue section techniques, the morphology, the size of the rhizome scales and their bearing position in the original plants of Gusuibu and its adulterants, i. e. Drynaria roosii, D. delavayi, D. quercifolia and Pseudodrynaria coronans were analyzed.</p><p><b>RESULT</b>There were significant differences between scales length of D. roosii, D. delavayi and P. coronans, while there was no significant difference between that of D. roosii and D. quercifolia. The scale teeth of D. delavayi were usually curved, bifid and uneven distributed at the scale fringe, which was different from that of the other three species. The base of the scales sinks in epidermis in D. roosii, D. quercifolia, and P. coronans, while it bore at the raised part of epidermis in D. delavayi.</p><p><b>CONCLUSION</b>[corrected] Morphology, size and bearing position of the rhizome scales have significant differences in the several species. Therefore, these characteristics can be applied to the identification of Gusuibu and its adulterants.</p>

Chemical constituents of petroleum ether extract of fruits of Schisandra sphenanthera / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents in the fruits of Schisandra sphenanthera.</p><p><b>METHOD</b>The constituents were isolated by their silica gel column, Sephadex LH-20 gel column, and their structures were elucidated by their chemical properties and spectroscopic analyses.</p><p><b>RESULT</b>Twelve compounds were isolated and identified as (+)-anwulignan (1), deoxyschizandrin (2), interiotherin A (3), schisantherin A (4), beta-sitosterol (5), schisantherin D (6), 4-hydroxybenzaldehyde (7), 6-O-benzoylgomisin O (8), schizandronic acid (9), schisanlactone D (10), schisanlactone B (11), kadsulactone A (12).</p><p><b>CONCLUSION</b>Compounds 3, 7, 10-12 were obtained from this plant for the first time.</p>

Investigation on the Diagnostic Value of CT and CTM in the Intravertebral Tumors / 中国医师杂志

Objective To investigate the value of Computed Tomography Myelography(CTM) and CT in diagnosis of in intravertebral tumors.Methods 35 tumors in the canales spinalis examined by CTM and CT and confirmed by surgical-pathologic results were retrospectively analyzed.Results 10 intramedullary(28 6%),15 intradural extramedullary(42 9%) ,8 intradural(22 9%) and 2 intra-extradural tumors(5 7%) were diagnosed respectively by CTM and CT.Conclusion CTM and plain and enhancement CT scanning can reveal the features of every kind of tumors in the canales spinalis and determine correctly respective position and nature.