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Objective:To report our clinical efficacy of pedicled transplantation of proximal thumb dorsal transverse flap to repair tissue defects at thumb pulp and fingertip.Methods:From February 2010 to November 2020, 97 patients with tissue defects at thumb pulp and fingertip were treated by pedicled transplantation of proximal thumb dorsal transverse flap at Department of Orthopedics, People's Hospital of Renqiu. They were 55 men and 42 women, aged from 17 to 66 years (average, 41.3 years). Altogether 55 right and 42 left sides were affected. The size of soft tissue defects ranged from 2.8 cm×1.8 cm to 3.9 cm×2.8 cm. Postoperatively, flap survival, shape, color and sensory recovery at the recipient area were observed; wound healing, function and complications at the donor site were also observed.Results:All the 97 flaps survived and all the wounds healed at the first stage. Blisters appeared at the distal end of the flap in only 2 cases but subsided 7 days after operation with no special treatment and the flaps survived smoothly. All the skin grafts at the donor site survived uneventfully. The 97 patients were followed up for 6 to 26 months (average, 10.7 months). Their flaps were not swollen, finger abdomen was full, finger appearance satisfactory, and finger feeling recovered well. The two-point discrimination at the last follow-up ranged from 4 to 11 mm (average, 7.6 mm). By the trial criteria for assessment of upper limb function suggested by Hand Surgery Society of Chinese Medical Association, sensory function of the affected finger was assessed as S 4 in 21 cases and as S 3+ in 76 cases at the last follow-up. No scar contracture was observed at the donor site and no movement restriction at the interphalangeal joint. Conclusion:Proximal thumb dorsal transverse flap is a reliable choice for reconstruction of complex tissue defects at thumb pulp and fingertip because of the advantages of easy harvest, constant vascular anatomy, full appearance and good sensory function at the recipient site, and limited damage to the donor site.
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Objective:To investigate the therapeutic effect of reverse proximal segment dorsal flap of radial digital artery of the thumb in repairing thumb tip defects.Methods:A retrospective case series study was conducted to analyze the clinical data of 56 patients with thumb tip defects admitted to Renqiu People 's Hospital from February 2010 to October 2020. There were 37 males and 19 females，aged 17-66 years［（37.8±12.2）years］. The injury on the right side was observed in 35 patients and on the left side in 21 patients. All of them were thumb tip defects with exposed distal phalanx. Dimension of skin defects was 2.9 cm×1.8 cm-3.3 cm×2.6 cm.The reverse proximal segment dorsal flap of thumb radial digital artery was used，with the dorsal digital nerve sutured with the proper digital nerve. The donor site was repaired with free skin graft from the ulnar side of the affected forearm. The time of flap harvesting，operation time and healing of the flap were measured. At the last follow-up，the shape，texture，sensory recovery and complications of the flap were observed. One month after operation and at the latest follow-up，the upper limb function evaluation standard set up by hand surgery branch of Chinese Medical Association and Vancouver Scar Scale（VSS）score were used to evaluate the recovery of sensory function of the flap and scar formation of the donor sites，respectively. Results:All patients were followed up for 6-26 months［（13.2±6.4）months］. The time of flap harvesting ranged from 20 to 35 minutes［（26.0±5.3）minutes］. The operation time was 1-2 hours［（1.3±0.3）hours］. Blisters appeared at the distal end of the flap in 2 patients after operation，but they were not treated. After 7 days，the blisters subsided and the flaps survived. The other flaps survived successfully. The donor sites healed by first intention. At the last follow-up，the flaps showed relatively cosmetic appearance，similarities in texture，elasticity and color to the surrounding area and good sensory recovery，without scar contracture and dystrophy of interphalangeal joint. According to the upper limb function evaluation standard set up by hand surgery branch of Chinese Medical Association，56 patients exceeded S3 grade compared to none at postoperative 1 month（ P<0.01），and the VSS score was 3-7 points［（5.0±1.4）points］compared to 6-12 points［（8.8±1.5）points］at postoperative 1 month（ P<0.01）. The donor site left a linear scar，which had no significant effect on its shape and function. Conclusion:The reverse proximal segment dorsal flap of the radial digital artery of the thumb can be used to repair thumb tip defects，for it has advantages of easy operation，a high survival rate as well as good appearance and sensory function recovery，with less damage to the donor area.
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Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the degeneration of upper and lower motor neurons selectively. Although the motor system lesion is the most predominant clinical manifestation of ALS, with the progression of the understanding of the pathogenesis and clinical detection of the disease, more and more patients are found to have extra-motor features of ALS, such as somatosensory involvement, etc. The research results demonstrated that ALS might be a kind of disorder combined with sensory disturbance according to the electrophysiology, neuropathology, neuroimaging, animal model simulation, genetic evidence, and other methods detected. We, herein, review the prevalence and detection methods especially the aspect of genetic associations implicated in the sensory nerve disturbance of ALS.
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Objective@#Throughing the investigation and analysis of seven cases of acute lung injury caused by a welding operation, the hazards and production pathways of harmful gases such as phosgene and nitrogen oxides are understood, which will serve as a reference for preventing similar events in the future.@*Methods@#Throughing the accident scene environment investigation and clinical case analysis, combined with the laboratory test results, carried on the comprehensive analysis.@*Results@#The accident caused a total of 7 people to suffer from acute lung injury to varying degrees. Three of them were sent to the ICU ward for treatment due to acute respiratory failure. After active treatment, 7 people were discharged from the hospital with obvious relief.@*Conclusion@#Welding is also a kind of profession that causes the high incidence of acute lung injury accidents. It is necessary to strengthen the knowledge training and protection awareness education of welding workers to avoid the occurrence of acute harmful gas poisoning accidents.
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Objective To investigate the effects of curcumin on myosin light chain kinase(MLCK)in the intestinal mucosa of rats with nonalcoholic fatty liver disease(NAFLD). Methods 35 SD rats were randomly di-vided into the normal control group ,the high fat group and the curcumin group. The high fat group ,curcumin group were given high fat diet for 16 weeks. After 8 weeks of high fat feeding in the curcumin group ,the rats were gavaged with 200 mg/(kg·d)curcumin for 8 weeks. The levels of ALT,AST,LPS and DAO in blood and expres-sion of MLCK in the intestinal mucosa were detected. The changes of liver pathology and tight junction(TJ)of the intestinal mucosa were observed. Results Compared with the control group,the blood levels of ALT,AST,LPS and DAO in the high fat group were obviously increased(P<0.05);Compared with the high fat group,the blood levels of ALT、AST、LPS and DAO in the curcumin group were obviously decreased (P < 0.05). In the high fat group ,hepatocellular steatosis was obvious ,while in the curcumin group hepatocellular steatosis was decreased. TJ was disrupted in the high fat group ,and the intercellular space was larger in the TJ group than the control group (P<0.05). The intercellular space was narrower in the curcumin group than the high fat group(P<0.05). The expression of MLCK in the high fat group was significant higher than that in the control group(P<0.05). The pos-itive staining in the curcumin group was significant lower than that in the high fat group (P < 0.05). Conclusion Curcumin can ameliorate hepatic steatosis by downregulating expression of MLCK in the intestinal mucosa of rats with NAFLD,improving TJ structure of the intestinal mucosa.
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Objective To investigate the effects of curcumin on myosin light chain kinase(MLCK)in the intestinal mucosa of rats with nonalcoholic fatty liver disease(NAFLD). Methods 35 SD rats were randomly di-vided into the normal control group ,the high fat group and the curcumin group. The high fat group ,curcumin group were given high fat diet for 16 weeks. After 8 weeks of high fat feeding in the curcumin group ,the rats were gavaged with 200 mg/(kg·d)curcumin for 8 weeks. The levels of ALT,AST,LPS and DAO in blood and expres-sion of MLCK in the intestinal mucosa were detected. The changes of liver pathology and tight junction(TJ)of the intestinal mucosa were observed. Results Compared with the control group,the blood levels of ALT,AST,LPS and DAO in the high fat group were obviously increased(P<0.05);Compared with the high fat group,the blood levels of ALT、AST、LPS and DAO in the curcumin group were obviously decreased (P < 0.05). In the high fat group ,hepatocellular steatosis was obvious ,while in the curcumin group hepatocellular steatosis was decreased. TJ was disrupted in the high fat group ,and the intercellular space was larger in the TJ group than the control group (P<0.05). The intercellular space was narrower in the curcumin group than the high fat group(P<0.05). The expression of MLCK in the high fat group was significant higher than that in the control group(P<0.05). The pos-itive staining in the curcumin group was significant lower than that in the high fat group (P < 0.05). Conclusion Curcumin can ameliorate hepatic steatosis by downregulating expression of MLCK in the intestinal mucosa of rats with NAFLD,improving TJ structure of the intestinal mucosa.
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AIM:To investigate the effects of glucagon-like peptide-1 (GLP-1) on mRNA expression of SOCS-3 and SREBP-1c in the rats with nonalcoholic fatty liver disease.METHODS:Male SD rats were randomly divided into normal control ( NC) group, high fat ( HF) group and HF+liraglutide ( Lira) group.The rats in HF group and HF+Lira group were given high-fat diet for 16 weeks.After 12 weeks of high-fat diet feeding in HF+Lira group, Lira (600μg? kg-1? d-1 ) was intraperitoneally injected for 4 weeks.At the end of the 16th week, the rats were killed.The pathologi-cal changes of the liver were observed under optical microscope.The serum levels of alanine aminotransferase ( ALT) , as-partate aminotransferase ( AST) , triglyceride ( TG) and total cholesterol ( TC) were detected by automatic biochemical an-alyzer.TG contents of liver were measured by GPO-PAP method.The fasting insulin ( FINS) was determined by ELISA, and insulin resistance index was assessed by homeostasis mode assessment ( HOMA-IR) .The mRNA expression of SOCS-3 and SREBP-1c in the liver tissues was detected by RT-qPCR.RESULTS:Compared with NC group, HOMA-IR, TG of liver, and the serum levels of ALT, AST, TG, TC and FINS in HF group were obviously increased (P duce TG of liver through decreasing the mRNA expression of SOCS-3 and SREBP-1c, so as to play a therapeutic role in nonalcoholic fatty liver disease.
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Objective To evaluate the efficacy of laparoscopic Habib 4X (Habib 4X,Angio Dynamics US),a new bipolar radiofrequency (RF) device,in laparoscopic liver resection.Methods Thirty one patients who underwent laparoscopic liver resection using the laparoscopic Habib 4X from Sept 2009 to Apr 2012 were studied retrospectively.Results The laparoscopic Habib 4X was success fully used in 30 patients (malignant,n=18; benign,n=12).The procedures performed included left lateral sectionectomy (n=12),left hemi-hepatectomy (n=1),Ⅴ or Ⅵ segmentectomy (n=9),Ⅴ and Ⅵ bi-segmentectomy (n=2) and wedge exclusion (n=6).The time required for precoagulation and resection was 10～68 min (median 24 min).The mean intraoperative blood loss was 145±75ml (range 8-370 ml).Mild abnormal liver function which returned to normal in 3 to 5 days was detected postoperatively.The mean hospital stay was 7.8±2.6 d (range 3～12 days).There was no patient who developed postoperative bleeding,bile leakage or abdominal abscess.For cancer patients,there was no local recurrence on follow-up.Conclusion Laparoscopic Habib 4X,a device when used in laparoscopic liver resection,resulted in minimal blood loss and quick recovery.It had only mild effect on liver function and it had low morbidity.In addition,it might reduce the risk of local recurrence in malignant tumours.
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Objective To analyze the clinical profile and short-term postoperative prognosis of mixed hepatocellular carcinoma and cholangiocarcinoma (mHCC-CC). Methods Clinical data of 17 mHCC-CC cases undergoing hepatectomy were retrospectively analyzed. Results Patients average age was 53 years (27～76 years).There were 11 males (64.7％) and 6 females.Ten patients (58.8％) were asymptomatic,twelve patients(70.6％ ) had positive serology for hepatitis B infection,serum AFP levels ＞25 ng/ml in 12 cases. Serum CA199 levels ≥ 37 U/ml in 4 cases. All patients underwent radical hepatectomy,including ＞ 1.5 cm safe margin and lymphadenectomy.The 6-,12-,and 18-months overall survival rate was 93.8％,86.5％ and 57.7％,respectively.The 100- and 200-day disease-free survival was 65.3％ and 43.5％.The median disease-free survival was 161 days. Conclusions mHCC-CC is difficult to diagnose preoperatively.The diagnosis depends on pathological examination.The main treatment was surgical resection.The prognosis of mixed primary liver cancer is poor and tends to recur early after hepatectomy.