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Objective:To study the anatomy of the perforator propeller flap of superior lateral genicular artery, and to explore a surgical method and clinical application in repair of the soft tissue defect of anterolateral knee with the flap.Methods:From September 2019 to September 2021, 8 knees of 4 chilled fresh specimen of adults were studied. The perforators of the superior lateral genicular artery were observed. The length, outer diameter of the perforators, and the locations of the skin perforation were recorded. The superior lateral genicular artery perforator propeller flaps were then applied clinically to 5 patients(3 males and 2 females) with soft tissue defects of anterolateral knee. Two of the patients had combined ligament injury and(or) bone joint exposure. The age of patients ranged from 25 to 48 years old, at 33.4 years old in average. The sizes of soft tissue defects ranged from 4.0 cm×4.0 cm to 8.0 cm×5.0 cm. The sizes of perforator propeller flaps of superior lateral genicular artery were 10.0 cm×5.0 cm to 13.0 cm×6.0 cm. The superior perforating vessels of the superior lateral genicular artery were found and marked at the points of skin perforation. Preoperative contrast-enhanced ultrasound were performed to confirm the dominant perforating vessels and had the skin perforating points marked. Intraoperative CDU were further performed to confirm the points of dominant perforating vessels. Perforator propeller flaps were designed depending on the size of the anterolateral soft tissue defect, and flaps were prepared and transferred to the defect sites. Postoperative follow-ups were conducted at outpatient clinic. The survival of the flap and knee function were observed according to the Bai-ly knee scoring.Results:The anatomy showed that an average pedicle length of the superior lateral genicular artery perforator was(8.2±0.9) cm, with an average starting outer diameter at(1.1±0.2) mm. All 5 flaps survived during the follow-up that lasted for 10 to 24 months, with an average of 15.3 months. All flaps healed in 2 weeks after surgery without complications such as soft tissue infection, bone and joint infection were observed. At the last follow-up, no obvious bloated appearance of the flaps were observed. The colour and elasticity of the flaps were similar to the surrounding skin. The knee function was assessed: 4 patients were in excellent and 1 in good. The range of knee flexion and extension was from 100° to 150°. The patients were satisfied with the appearance and function of the knees.Conclusion:The size of the perforator of superior lateral genicular artery and the pedicle length are ideal. The propeller flap can be used to repair the soft tissue defect around the anterolateral knee, with satisfactory functional recovery of a knee. It is a good method to repair the soft tissue defect around anterolateral knee.
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Objective:To explore the association between attitudes toward care of the dying and death depression in undergraduate nursing students.Methods:With stratified sampling, 380 undergraduate nursing students in Guangdong Medical University from June to September 2020 were investigated by using a self-designed questionnaire, Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B-C) and Chinese version of Death Depression Scale-Revised (CCDS-R). Pearson correlation analysis was used to analyze the correlation between hospice care attitude and death depression of nursing undergraduates.Results:The score of FATCOD-B-C of 380 nursing undergraduates was (104.92 ± 7.92) points. The highest average score of dimensions of attitude toward the necessity of family support was (4.02 ± 0.38) points, and the lowest average score of dimensions of attitude toward communication with the dying person was (2.95 ± 0.42) points. The score of CCDS-R was (54.58 ± 12.52) points. The highest average score of dimensions of other death was (3.48 ± 0.80) points, and the lowest average score of dimensions of existential vacuum was (1.78 ± 0.69) points. Pearson analysis revealed that attitudes toward care of the dying had a negative association with death depression ( r=-0.34, P<0.05). Conclusions:Attitudes toward care of the dying of undergraduate nursing students is in a higher level and it has close association with death depression. It is recommended to reduce the death depression level of undergraduate nursing students through hospice care training and carrying out death education, so as to improve the positive attitudes of caring for dying patients.
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Objective:To study the correlation between type 2 innate lymphocyte (ILC2) and Treg/Th17 ratio in the peripheral blood of patients at different stages of Mycobacterium tuberculosis ( Mtb) infection. Methods:This study recruited 30 individuals with active tuberculosis (ATB group), 26 with treated tuberculosis (RTB group), 22 with latent tuberculosis infection (LTBI group) and 17 negative for tuberculin skin test (TST-negative group). Flow cytometry was used to detect the proportion of ILC2 in CD45 + cells, and that of Th17 and Treg cells in CD4 + T lymphocytes in the peripheral blood of patients in each group. Expression of Foxp3 and RORγt at mRNA level was detected by real-time fluorescence quantitative PCR. Pearson method was used to analyze the correlation between Th17 and Treg, and that between ILC2 and Treg/Th17 ratio in the peripheral blood of patients with ATB and RTB. Results:The proportions of ILC2 in RTB and ATB groups were significantly higher than those of LTBI and TST-negative groups, and the proportion of ILC2 in RTB group was significantly higher than that of ATB group ( P<0.05). The proportion of Th17 in RTB group was lower than that of ATB group ( P<0.05), and the proportions of Th17 in ATB and RTB groups were lower than those of LTBI and TST-negative groups. The proportion of Treg in RTB group was lower than that of ATB group ( P<0.05), and close to that of LTBI group and TST-negative group, but the Treg/Th17 ratios in ATB and RTB groups were higher than those of LTBI and TST-negative groups. There was no significant difference in Treg/Th17 ratio between ATB and RTB groups ( P>0.05). The expression of Foxp3 and RORγt at mRNA level and Foxp3/RORγt ratio changed accordingly. Meanwhile, there was no correlation between Th17 and Treg in ATB or RTB group ( r=0.023, P=0.444; r=0.428, P=0.150). There was a positive correlation between ILC2 and Treg/Th17 ratio in ATB group ( r=0.794, P=0.000), while no correlation was found between ILC2 and Treg/Th17 ratio in RTB group ( r=0.197, P=0.297). Conclusions:In this study, the proportion of ILC2 was increased in the peripheral blood of TB patients, and the proportion of ILC2 in RTB group was higher than that of ATB group. In RTB group, Th17 accounted for a low proportion in the peripheral blood and was involved in inflammatory reactions, while Tregs were not involved in inflammatory reactions, but might have a certain inhibitory effect in patients with ATB. Further studies found that Th17-involved inflammatory reactions were not regulated by Tregs. ILC2 was involved in Treg/Th17 imbalance in ATB patients, but not in RTB patients.
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Objective: To explore the in hibitory effects of zingerone in combination with sorafenib on t h e migration and invasion of human liver cancer HepG2 cells, and to clarify their relative mechanisms. Methods: The HepG2 cells were treated with different concentrations of zingerone and sorafenib alone or in combination. The cell poliferation rate was determined by M T T assay. The appropriate concentrations of zingerone and sorafenib were selected according to the results. The experiment was divided into control group (D M S O), zingerone group (30 umol • L_ 1 ), sorafenib group (3 umol • L_ 1 ) and combination group (zingerone 30 umol • L_ 1 + sorafenib 3 umol • L_ 1 ) . The scratch healing rate was measured by cell wound healing test; Transwell assay was used to detect the number of transmembrane cells in each group. The expression levels of MMP-2 and MMP-9 were determined by Western blotting method. Results: Compared with control group, the proliferation rates of the HepG2 cells in zingerone group and combination group were significantly decreased (P < 0 . 01). Compared with control group, the scratch healing rates of the HepG2 cells in zingerone group and sorafenib group were reduced (P < 0 . 05); the scratch healing rate in combination group was significantly lower than those in zingerone group and sorafenib group (P < 0 . 01). In the Transwell experiment, the number of transmembrane cells in zingerone group and sorafenib group was decreased compared with control group (P < 0 . 05); the number of transmembrane cells in combination group was significantly lower than those in zingerone group and sorafenib group (P < 0 . 01). The Western blotting results showed the expression levels of MMP-2 and MMP-9 in the HepG2 cells in zingerone group and sorafenib group were lower than those in control group (P < 0 . 05), and the expression levels of MMP-2 and MMP-9 in combination group were significantly lower than those in zingerone group and sorafenib group (P < 0. 01). Conclusion: Zingerone can inhibit the migration and invasion of the human hepatoma cells by decreasing the expressions of MMP-2 and MMP-9 proteins in the HepG2 cells, and it has better effect with sorafenib.
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Objective To investigate the impaired characteristics of working memory in Parkinson's disease patients with depression and the recovery status of working memory after antidepressant treatment.methods Totally 60 cases were enrolled in this study and divided into three groups:30 Parkinson's disease patients with depression (PD-D),15 Parkinson's disease patients without depression (PD) and 15 persons without Parkinson's disease as normal controls.All subjects were evaluated with Wechsler Memory Scale (WMS-R) audio-visual span,Tower of Hanoi (TOH) and Wisconsin Card Sorting Test (WCST).30 PD-D patients were randomly divided into two subgroups:routine treatment subgroup (8 weeks levodopa therapy) and antidepressant combined treatment subgroup (8 weeks levodopa + citalopram therapy).The evaluation of Hamilton Depression Scale (HAMD),WMS-R audio-visual span,TOH and WCST were performed on these two groups before and after treatment.Result s① There were significant differences comparing PD-D and PD groups with the normal control group in scores of WMS-R,TOH and WCST indicators (P<0.05).There were significant differences in WMS-R visual span,accuracy rate and speed of TOH,as well as the percent errors and percent perseverative responses of WCST comparing PD-D group(11.88±5.91,0.420±0.345,0.408±0.334,0.882±0.253,0.565±0.229) with PD group (15.87±5.21,0.768±0.167,0.634±0.232,0.493±0.161,0.327±0.122) (P<0.05).② Before and after treatment in PD-D routine treatment subgroup,there were significant differences in digital memory and audio-visual memory of WMS-R((6.73±3.72,5.95±3.13) vs (3.77±2.16,1.91±1.58)),accuracy rate of TOH(0.45±0.26 vs 0.23±0.13),as well as percent errors((-0.58±0.17) vs (-0.37±0.14)),percent perseverative responses((-0.32±0.15) vs (-0.14±0.09)),percent conceptual level responses(0.38±0.09 vs 0.13±0.07) and number of categories completed(3.27±1.56 vs 1.06±0.91) of WCST(P<0.05).③ After 4-week treatment and 8-week treatment,there were significant differences in HAMD score comparing PD-D antidepressant combined treatment group(16.33±2.72,10.27±2.66) with PD-D routine treatment group(21.73±2.28,18.4±2.47) (P<0.05).Conclusion Comparing Parkinson's disease patients without depression,the impaired working memory is more serious and extensive in Parkinson's disease patients with depression.Antidepressant treatment can improve the working memory of Parkinson's disease patients with depression.
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Objective To evaluate CT and MRI findings of portal vein aneurysm(PVA)in order to improve its diagnostic accuracy.Methods CT and MRI findings of 9 patients with PVA proved by pathology and direct angiography were reviewed retrospectively.CT scanning was performed in 7 patients,including plain scan (n=2),both plain and enhanced scan (n=5),CT angiography (CTA)(n=3).Plain and enhanced MRI scan were performed in 3 patients.Results (1 )PVA showed a high predilection for old adults.(2 )Of the 9 tumors,4 located in portal vein trunk,2 located in junction of superior mesenteric vein and portal vein trunk,1 located in intrahepat-ic-extrahepatic portal vein,2 located in intra-hepatic portal vein.(3)8 tumors were characterized as well-defined and quasi-circular mass.1 patient occurred portal hypertension,thrombus as the portal vein trunk was oppressed by the tumor.(4)Plain CT showed the mass was slightly higher than pancreas parenchyma density,and uniform with the density of the liver parenchyma.Enhancement scanning showed 4 tumors represented mild or moderate enhancement in portal venous phase except for 1 patient accompany with portal vein thrombus.CTA showed clearly the relationship mass with portal vein,and classified the type of PVA .The 3 lesions represented hypo-intensity on T1 WI and even hyper-intensity on T2 WI.Enhancement scanning showed the tumor was significantly enhancement in portal venous phase on T1 WI.Conclusion CT and MRI have their own advantages in the diagnosis of portal vein aneurysm.Com-bination of CT and MRI could improve the diagnostic accuracy of portal vein aneurysm.
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Aim To investigate the effect of intrathecal injection of CCR2 antagonist on pain behaviours,spinal astrocytes activation in the spinal cord in a rat model of bone cancer pain. Methods Forty female SD rats weighing 150 ~180 g were randomly divided into five groups ( n=8 each ):(Ⅰ) sham group;(Ⅱ) sham +RS102895 group;(Ⅲ) bone cancer pain group;(Ⅳ) bone cancer pain + DMSO group;(Ⅴ) bone cancer pain+RS102895 group. Rats received i. t. injections of either RS102895 (3 g·L-1 ) 10 μl or 10%DMSO 10 μl at the time of 10-12 days after the operation. Bone cancer was induced by intra-tibial inoculation of 1 × 105 Walker 256 breast cancer cell. Mechanical hind paw withdrawal threshold test was performed one day before and at 3rd,6th,9th, 10th,11th and 12th days after surgery. Immunofluorescence was used to observe the activation of the spinal astrocytes. Results Compared with group Ⅰ, the rats in bone cancer pain group appeared obvious mechanical hyperalgesia (Ⅲ、Ⅳ、Ⅴ) ,the volume,shape and mean optical den-sity ( MOD) of spinal astrocytes could be seen obvious-ly increased,groupⅡhad no obvious statistical signifi-cance (P>0. 05). Compared with group Ⅳ ,i. t. in-jections of RS102895 increased the paw mechanical withdrawal threshold, suppressed the action of astro-cytes,reduced the MOD of spinal astrocytes. Conclu-sion CCR2 might participate in the formation of bone cancer pain via activating spinal astrocytes. CCR2 will be a potential target for the treatment of bone cancer pain.
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Objective To evaluate the role of spinal microglial C-C chemokine receptor type 2 (CCR2) in the maintenance of bone cancer pain (BCP) in rats.Methods Fifty unmated female Sprague-Dawley rats,aged 2 months,weighing 160-180 g,were randomly divided into 5 groups (n =10 each):sham operation group (group Ⅰ),sham operation + RS102895 (CCR2 antagonist) group (group Ⅱ),BCP group (group Ⅲ),BCP + dimethylsulfoxide (DMSO) group (group Ⅳ),and BCP + RS102895 group (group Ⅴ).The rats were anesthetized with intraperitoneal chloral hydrate.BCP was induced by intra-tibial inoculation of 1 × 105 Walker 256 mammary gland carcinoma cells into the medullary cavity of the left tibial metaphysis.On 10-12 days after operation,3 μg/μl RS102895 10 μd was injected intrathecally once a day in Ⅱ and Ⅴ groups,10％ DMSO 10 μl was injected intrathecally once a day in Ⅳ group,and normal saline 10 μl was injected intrathecally once a day in Ⅰ and Ⅲ groups.Mechanical paw withdrawal threshold was measured at 1 day before operation and 3,6,9,10,11 and 12 days after operation.After measurement of pain threshold at day 12 after operation,the lumbar segments (L4-6) of the spinal cord were removed for determination of the level of ox-42 (spinal microglial activation marker) (by immuno-histochemistry) and contents of IL1-β,IL-6 and TNF-α (by ELISA).Results Compared with group Ⅰ,mechanical paw withdrawal threshold was significantly decreased at 6-12 days after operation,the number of ox-42 positive cells and contents of IL1-β,IL-6 and TNF-α were increased in Ⅲ,Ⅳ and Ⅴ groups,and no significant change was found in the parameters mentioned above in group Ⅱ.Compared with group Ⅲ,mechanical paw withdrawal threshold was significantly increased at 10-12 days after operation,the number of ox-42 positive cells and contents of IL1-β,IL-6 and TNF-α were decreased in group Ⅴ,and no significant change was found in the parameters mentioned above in group Ⅳ.Conclusion Spinal microglial CCR2 is involved in the maintenance of BCP via activating microglia and promoting the release of inflammatory cytokines of rats.
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Objective To evaluate the role of c-Jun N-terminal kinase (JNK)/monocyte chemoattractant protein-1 (MCP-1) signaling pathway in the spinal cord in the maintenance of bone cancer pain (BCP) in rats.Methods Fifty female Sprague-Dawley rats,weighing 150-180 g,were randomly divided into 5 groups (n =10 each) using a random number table:sham operation group (group S),sham operation + JNK inhibitor SP600125 (group SP),BCP group,BCP + dimethyl sulfoxide (DMSO) group,and BCP+ SP600125 group (group BCP+ SP).BCP was induced by injecting Walker 256 mammary gland cancer cells into the bone marrow of the left tibia.On 10-12 days after BCP,SP600125 10 μg(10 μ1) was injected intrathecally once a day in SP and BCP + SP groups,and 5％ DMSO 10 μl was injected intrathecally once a day in BCP + DMSO group.Mechanical paw withdrawal threshold (MWT) was measured at 1 day before BCP and 3,6,9,10,11 and 12 days after BCP.After measurement of MWT at 12 days after BCP,the rats were sacrificed and L4-6 segments of the spinal cord were removed for determination of MCP-1 expression by using immuno-histochemistry and Western blot.Results Compared with S group,MWT was significantly decreased at 6-12 days after BCP,MCP-1 expression was upregulated in BCP,BCP + DMSO and BCP + SP groups (P ＜ 0.01),and no significant change was found in the parameters mentioned above in SP group (P ＞ 0.05).Compared with BCP group,MWT was significantly increased at 10-12 days after BCP,MCP-1 expression was down-regulated in BCP + SP group (P ＜ 0.01),and no significant change was found in the parameters mentioned above in BCP + DMSO group (P ＞ 0.05).Conclusion JNK/MCP-1 signaling pathway in the spinal cord may be involved in the maintenance of BCP in rats.
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Electrocardiogram generation principle is the foundation of learning electrocardiogram and contains the knowledge system of the electrocardial vector,projection and lead system.Teaching contents should be appropriately selected according to the inner logic of the above three knowledge systems and the teaching rule.In classroom teaching,the knowledge of the lead system should be taught by step one,the knowledge of electrocardial vector should be taught by step two and the knowledge of projection should be taught by step three.The three steps help students understand and grasp the mechanism which causes the electrocardiogram more easily.
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<p><b>OBJECTIVE</b>To detect the effect of andrographolide on apoptosis of Candida albicans biofilm dispersion cells.</p><p><b>METHOD</b>The morphological changes of apoptotic C. albicans biofilm cells were observed by using Hoechst 33258 staining Fluorescence microscope; changes of mitochondrial membrane potential (MMP) of C. albicans biofilm cells were detected by rhodamine 123 staining flow cytometry; and reactive oxygen species (ROS) was detected by DHR staining flow cytometry.</p><p><b>RESULT</b>1 000, 100 micromol x L(-1) of andrographolide could cause pyknosis and dense staining of C. albicans biofilm cells, 1 000, 100, 10 micromol x L(-1) of andrographolide could decrease MMP and increase ROS of C. albicans biofilm cells.</p><p><b>CONCLUSION</b>Andrographolide of appropriate concentrations could induce apoptosis of dispersion cells of C. albicans biofilms.</p>
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Antifungal Agents , Pharmacology , Apoptosis , Biofilms , Candida albicans , Physiology , Diterpenes , Pharmacology , Membrane Potential, Mitochondrial , Reactive Oxygen Species , MetabolismABSTRACT
Objective To investigate the surgical operation technique,clinical curative effect and the choice of the indication in the treatment of cervical spondylosis by radiofrequency nucleoplasty.Methods From January to July in 2006,the ArthroCare system 2000 radio frequency instrument that the American ArthroCare company produce were odopted,to treat 20 patients with cervical spondylosis by radiofrequency nucleoplasty under the leading of the C form grill X-ray fluoroscopic machine.Among them,there were 9 males and 11 females with age from 38 to 62 years,equally 45.12 years old,the average course of illness was 2 years. 15 cases with lumbar disc herniation,4 cases with nerve-root cervical sDandylosis and 1 case with spinal cervical spondylosis.Single segment affection in 4 cases,double or multistage segment affection in 16 cases.Among those multistage segment eases,all choose 2 segments for research according to fixed physical sign the body advertise for and the MRI image.After the operation all cases underwent follow-up.with follow-up time for 1-6 months.Results The results shown an effect among those 20 sufferers of excellence in 16 cases,valid in 4 cases,efficient power reach to 100%in short term.Ahhough this case was limited.the early case choice compares strictly,the subjective satisfaction of sufferer was higher.Conclusion Application of radiofrequency nucleoplasty in the treatment of cervical sDondylosis has advantages of small wound,safety and high efficacy in short term.However, its indication still need further research.
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0.05).Conclusion Acupuncture has an effect on I/O curve amplitude of EPSP and PS,and on LTP induction of PS of dentate gyrus(DG) in rats after cerebral ischemia.However,the difference of effect of acupuncture at different doses on LTP induction is insignificant.
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[Objective] To observe the protective effect of acupuncture on ischemic cerebral damage. [Methods] SD rats were randomized into 2-week sham-operation (2W-SO) group (n=6) , 5-week sham-operation (5W-SO) group (n =6) , 2-week cerebral-ischemia (2W-CI) group (n-6) , 5-week cerebral-ischemia (5W-CI) group ( n = 6), 2W-CI + electroacupuncture (EA) group (n=6) and 5W-CI + EA group (n=6) . Except the sham-operation groups, cerebral ischemia was induced by heat-occlusion of middle cerebral artery in other groups. Changes of nerve growth factor (NGF) expression were monitored in ischemic cortex of rats with 2-week and 5-week ischemia by immunohistochemical method, and the effect of electroacupuncture (EA) was observed. [Results] Few NGF-positive cells were found in the ischemic cortex of sham-operation groups and the expression of NGF were obvious in cerebral ischemia groups as compared with the sham-operation groups ( P