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Objective:To investigate the clinical effect of thoracoumbilical flap combined with random abdominal flap in repair of large-area soft tissue defects of calf in children.Methods:The clinical data of 16 children with large-area soft tissue defects of calf treated with thoracoumbilical flap combined with abdominal random flap from January 2004 to December 2007 in PLA Trauma Orthopaedic Research Institute, 80th Group Military Hospital of the PLA were retrospectively analysed. There were 7 boys and 9 girls aged 8 to 14(11.3 in average) years old. Six cases were crushed by heavy objects, 6 crushed by wheels, 3 by thermal press and 1 by machine strangulation. After thorough debridement, the wound area ranged from 16.0 cm×9.0 cm to 38.0 cm×15.0 cm. Four cases were treated after 3-10 hours of injury by emergency surgery. Twelve cases received surgeries 0-11 days after hospital admission and wound being stabilised. Doppler ultrasound was used to locate the perforating vessels according to the location, size and shape of the wound. Thoracoumbilical flap combined with abdominal random flap were designed and harvested to repair the wound. The sizes of flaps were 18.0 cm×11.0 cm-40.0 cm×16.0 cm. All patients entered follow-up at the outpatient clinic or through WeChat interviews. The appearance, texture of the flap and limb recovery were checked and recorded.Results:After surgery, all of 16 flaps survived, of which 12 flaps had phase-one healing, 3 flaps had small area of necrosis at the edge, which healed after repeated dressing changes and 1 flap developed vascular comproise, and survived after surgical exploration. The donor sites healed in phase-one. All 16 children had 6 months to16 years of follow-up, with an average of 20.7 months. The colour of the flaps was normal with soft texture. The motor function of calf was satisfactory. According to Punor functional evaluation criteria, 12 cases were in excellent and 4 in good.Conclusion:The thoracoumbilical flap combined with abdominal random flap features a reasonable design, strong blood supply and repair of a large area. It is a reliable method for repairing large area soft tissue defects in the calf of children.
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Objective:Anatomical study of the cross-donor flap pedicled with the peroneal artery and the discussion of the effect of clinical application, so as to describe a new method for the repair of large-area soft tissue defects in the foot and ankle.Methods:From June 2016 to August 2019, 12 specimens of adult lower limbs were studied. The popliteal arteries were perfused with perchloroethylene-ethyl acetate-lead oxide and red perchloroethylene-ethyl acetate. The origin, number, outer diameter, course and distribution of perforating branches of the peroneal artery were anatomically observed. The source, distribution and anastomosis of the skin nutrient vessels in the posterolateral area of the calf were also studied. Relationship of the blood supply between the peroneal arteries and veins and the nutritional vessels of the sural nerve were observed. In 9 patients, the peroneal artery and vein were designed as the pedicle of cross-donor flap in the repair of large soft tissue defects of foot and ankle. The patients were entered follow-up through outpatient visits and telephone interviews.Results:Among the 12 adult specimens of lower limbs, there were 65 perforating branches from the peroneal artery, 4-7 branches on each side, with an average of (5.41±1.00) branches. The diameter of the penetrating deep fascia was(1.07±0.36) mm. The perforator branches were mostly distributed in 3 sections of 4.0-11.0 cm, 16.0-21.0 cm and 24.0-27.0 cm away from the lateral malleolus, accounting for 48%, 24% and 17% of the total number of perforators, respectively. The outer diameters of the perforator vessels were (0.92±0.26)(0.56-1.68) mm, (1.32±0.38)(0.60-2.14) mm, and (0.98±0.28)(0.62-1.36) mm. The length of the pedicle of the perforator vessels were (3.91±0.96)(2.15-5.78) cm, (5.34±0.50)(4.01-5.85) cm, and (3.31±1.15)(2.16-5.66) cm. The perforating branches in the 3 sections appeared constantly. The diameter of the vessels was≥0.5 mm with an average length of at(4.19±1.16)(2.15-5.85) cm. The vascular network of the flap in the posterolateral area of the calf was mainly composed of subdermal vascular network and deep fascial vascular network. The deep fascia vascular network in the posterolateral area of the calf had 3 obvious longitudinal chains, including the medial sural neurotrophic vascular chain, the small saphenous vein-sural nerve communicating branch vascular chain and the lateral sural neurotrophic vascular chain, which took the nutrient blood supply from the perforating branches of the peroneal artery also formed a longitudinal and transverse anastomosis between the perforating branches of the peroneal artery. In the clinical trials performed on 9 patients, all soft tissue defects of foot and ankle were repaired. The composite tissue flap survived without infection or necrosis. The follow-up was lasted for 12 months to 3 years. The postoperative function and the donor site appearance were good and the patients walked normally. According to the American Orthopaedic Foot and Ankle Association(AOFAS) foot scoring standard, the function of affected feet were evaluated. Five patients were excellent and 4 were good.Conclusion:The cross-donor flaps pedicled with peroneal arteries and veins has sufficient blood supply and a large area. It provides a method for the repair of large-area soft tissue defects in the foot and ankle.
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The distal radius and the proximal row of carpal joints are important components of the carpal joint. Injury to the distal radius may result in decreased range of motion and strength of the wrist, and changes in the wrist appearance can hurt the patients. Developing microsurgical techniques, and updating orthopedic metal instruments and bone biological products provide more possible means for surgical reconstruction. Currently, reconstruction of the distal radius with autologous bone grafting is the mainstream surgical method, and the fibula and ilium are the main options for grafting. Moreover, other repair methods have also been reported, such as prosthetic repair and repair using the ulna to replace the radial function. This article reviews the main forms of surgical repair and reconstruction after distal radius injury reported in recent years, compares the clinical effects of different surgical methods, and summarizes the advantages and disadvantages of each surgical method, hoping to provide useful information for the treatment of distal radius injury.
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Objective:To analyze the feasibility of applying transcutaneous electrical nerve stimulator and high-frequency ultrasound in superficial nerve positioning for detection anatomical location in the area of lateral lip of the iliac crest by lateral cutaneous branch of subcostal nerve(LCSN). The significance of using the nerve as a free sensory superficial circumflex iliac artery perforator flap was discussed.Methods:The data of patients who underwent the repair of defects on limbs with free perforator flap or composite flap of superficial iliac circumflex artery carrying sensory nerve and the volunteers who agreed to have the location of the LCSN measured between October, 2018 and October, 2020 were collected. The LCSN were located by percutaneous electrical nerve stimulation and ultrasound, and the patients were measured and located during surgery. Using Passing-Bablok regression and Bland-Altman graph to evaluated the consistency between transcutaneous electrical nerve stimulation, ultrasound and the surgical positioning.Results:A total of 43 subjects, including 22 patients and 21 volunteers, were selected for locating the LCSN. Thirty-nine males and 4 females, with an average age of 39 years old and an average BMI of 24.08. The operation time of percutaneous nerve electrical stimulation was(6±1) min, and the detection distance was(80.7±5.9) mm. The high-frequency ultrasound was(23±4) min, and the distance was(81.2± 6.6) mm. The average operation time of surgical measured distance was(80.9±8.2)(65-100) mm, the diameter of nerve was(2.3±0.8)(1.0-4.0) mm, and the operation time was(5±1) min. A 95% CI of Passing-Bablok regression intercept and slope of operation, percutaneous electrical nerve stimulation and ultrasoundincluded 0 and 1, respectively. The points on Bland-Altman plot were distributed on both sides, and 95% CI of total mean difference, total intercept and slope included 0. Therefore, it was can be considered that the application of percutaneous electrical nerve stimulation and ultrasound in LCSN localization has good consistency.Conclusion:The location point of the LCSN crossing the iliac crest which detected by transcutaneous electrical nerve stimulation and high-frequency ultrasound detection was close to the measurement taken during the operation. It was also showed that both of them can be used for preoperative locationing of the sensory branch of the sensory nerve flap, optimizing the design of the flap, shortening the operation time, and reducing the unnecessary injury in operation.
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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.
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Objective:Dysregulated host immune responses contribute to the pathogenesis of sepsis. G protein-coupled receptor 174 (GPR174) was found to be involved in the immune responses and associated with the susceptibility to autoimmune diseases. This study aimed to investigate the association of GPR174 variants with sepsis susceptibility and the contribution of GPR174 in sepsis development.Methods:From May 2005 to December 2017, a total of 575 sepsis patients and 579 non-septic controls admitted to our Emergency ICU were enrolled in this case-control study. The non-synonymous SNP rs3827440 in GPR174 was genotyped using TaqMan Real-time PCR assays on ABI7900 platform. Then the correlation between rs3827440 and serum levels of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) were investigated in septic patients. Gpr174-deficient mice were generated and subjected to cecal ligation and puncture (CLP). The concentrations of inflammatory cytokines were measured by enzyme-linked immunosorbent assay (ELISA).Results:Rs3827440 TT/T genotype in GPR174 was positively associated with sepsis risk after logistic regression analysis adjusted for sex [odds ratio ( OR) = 1.68, 95% confidence interval ( CI): 1.19-2.20, P = 0.0004]. IL-6 and TNF-α serum levels in female TT and male T allele carriers of septic patients were significantly higher than those in female CC and male C allele carriers ( P < 0.05). Preclinical validation of Gpr174 gene was performed in Gpr174 knockout (KO) mice using CLP models. Gpr174 KO mice had higher survival rate. Moreover, Gpr174 KO mice had significantly decreased serum concentrations of IL-1β, IL-6 and TNF-α compared with WT mice, while the levels of IL-10 was increased ( P < 0.01). Conclusions:GPR174 as a novel sepsis susceptibility gene in Chinese Han population is involved in the development and physiopathology of sepsis.
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Objective To construct evaluation index system of training effectiveness for new recruiting nurses based on the theory of Kirkpatrick Model. Methods The draft of evaluation index system of training effectiveness for new recruiting nurses was drawn up through literature survey and interview method first, and then it was constructed by using Delphi method and statistical analysis. Results Through two rounds of expert consultations, the experts′ suggestions were revised and summarized, and then the evaluation index system was constructed, including 4 grade I indexes, 14 gradeⅡindexes, and 56 gradeⅢindexes. The positive coefficients of the two rounds of expert consultation were 96.15% and 100.00% , respectively, with authoritative coefficient of 0.877. The Kendall Harmony Coefficients of importance and operability of grade I, Ⅱ, and Ⅲ indexes were 0.640, 0.378, 0.296, and 0.707, 0.515, 0.416, respectively (P< 0.01). Conclusions The enthusiasm, authority level and coordination degree of the experts were all at a high level. The evaluation index system of training effectiveness for new recruiting nurses was of high importance and operability.
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Objective To explore the efficacy and safety of two antibody induction therapies during donor after cardiac death (DCD) kidney transplantation .Methods Retrospective analysis was performed for the clinical data of DCD kidney patients in 2016 .Patients using basiliximab monoclonal or thymoglobulin (ATG ) polyclonal antibody were divided into two groups . Early postoperative biopsy proven ,acute rejection rate ,creatinine level and patient/graft survival rate were compared between two groups at 1 ,3 or 6 month post-operation .Results Basiliximab (n=44) and ATG (n=60) was used as induction .No significant inter-group difference existed in donor age ,primary disease , creatinine pre-donation , recipient age or cause of renal failure . And recipient male ratio and body weight were greater in ATG group than those in basiliximab group [87％ vs .55％ ;(70 ± 13) vs .(64 ± 12) kg] .Outcomes of basiliximab group showed acute rejection rate was 9％ ,average creatinine 112 .4 at 1 month ,127 .0 at 3 months and 107 .8 at 6 months and total infection rate 16％ .Graft/patient 6-month survival rates were 95％ (42/44)and 98％ (43/44) .Outcomes of ATG group showed that acute rejection rate was 3％ ,average creatinine 135 .6 at 1 month ,119 .0 at 3 months and 118 .0 at 6 months and total infection rate 22％ .Graft/patient 6-month survival rates were both 100％ (60/60) .Conclusions During DCD kidney transplantation ,both induction therapies may prevent acute rejection immediately post-operation .No difference exists in acute rejection rate ,infection rate ,graft/recipient 6-month survival rate or graft function . These two inductions have an excellent early prognosis .
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Objective@#To construct evaluation index system of training effectiveness for new recruiting nurses based on the theory of Kirkpatrick Model.@*Methods@#The draft of evaluation index system of training effectiveness for new recruiting nurses was drawn up through literature survey and interview method first, and then it was constructed by using Delphi method and statistical analysis.@*Results@#Through two rounds of expert consultations, the experts′ suggestions were revised and summarized, and then the evaluation index system was constructed, including 4 grade I indexes, 14 grade Ⅱindexes, and 56 grade Ⅲ indexes. The positive coefficients of the two rounds of expert consultation were 96.15% and 100.00%, respectively, with authoritative coefficient of 0.877. The Kendall Harmony Coefficients of importance and operability of grade I, Ⅱ, and Ⅲ indexes were 0.640, 0.378, 0.296, and 0.707, 0.515, 0.416, respectively (P< 0.01).@*Conclusions@#The enthusiasm, authority level and coordination degree of the experts were all at a high level. The evaluation index system of training effectiveness for new recruiting nurses was of high importance and operability.
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Objective To investigate the clinical effect of donor kidneys in rhabdomyolysis(RM) combined with acute kidney injury(AKI).Methods A retrospective analysis was made on the clinical data of 10 donors with RM and 14 cases of renal transplantation from March 2017 to May 2018.Results AKI was caused by RM in 10 donors.Before harvesting the donor kidneys,blood creatine kinase (CK) level was (14 005.19 ± 11 894.27) U/L in 10 donors,plasma myoglobin level was ＞3 000 μg/L in 7 cases,and that was (2 288 ± 680) μg/L in 3 cases.LDH level was 883 ± 453 IU/L and serum creatinine (Cr) value was (216.55 ± 125) μmol/L.6 donors received continuous renal replacement therapy.Six patients with delayed renal function recovery (DGF) were treated with CRRT.The duration of GDF was 3-20 days,with an average of 10 ± 6.6 days.All the patients were followed up for 3-15 months.The glomerular filtration rate was (40.19 ± 19.55) ml·min· 1.73 m-2 and (55.01 ± 15.94) ml · min· 1.73 m-2 at 1st and 3rd month after operation,respectively.Conclusion The incidence of DGF in donor kidneys with RM and AKI is high,and the short-term effect is satisfactory.The long-term effect needs to be further observed.
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<p><b>OBJECTIVE</b>This study aims to investigate the characteristics and general rules of adverse drug reactions (ADR) in a 3A-grade stomatology hospital for safe and rational drug use in clinical stomatology.</p><p><b>METHODS</b>We retrospectively analyzed 52 ADR cases (1∶1.36, males∶females) reported in the West China Hospital of Stomatology of Sichuan University from 2014 to 2016 in terms of gender and age distributions, drug categories, and clinical manifestations.</p><p><b>RESULTS</b>Eight kinds of drugs and antibiotics were predominately used [24 cases, 46.15% (24/52)], followed by nutrition drugs and antitumor drugs. Cephalosporin was the leading antibiotic drug associated with ADR [20 cases, 83.33% (20/24)]. Intravenous infusion was the most common route of drug administration [49 cases, 94.23% (49/52)]. The most common manifestations of the ADR were damages of the skin and its appendages and lesions of the digestive and nervous systems.</p><p><b>CONCLUSIONS</b>Strengthening the ADR monitoring system and further management should be implemented to alleviate ADR in stomatology hospitals.</p>
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Objective To investigate the relationship of acute graft versus host disease (aGVHD) and the regulatory T (Treg) cells,NK cells as well as their function-related cytokines such as IL-10,TGF-β,and perforin in mice with allogeneic bone marrow transplantation.Methods H-2 completely mismatched C57BL/6→ BALB/c aGVHD mice model was constructed.Flow cytometry analysis was used to detect the proportion of CD4+CD25 + Treg cells and NK-1.1+ NK cells in the spleen of aGVHD mice after transplantation.ELISA method was used to detect the serum levels of IL-10,TGF-β and perforin in the aGVHD mice intervened with CSA prophylactic or not.The normal C57BL/6 mice were used as controls.Results Compared with those of normal mice,the proportion of Treg cells in aGVHD mice after transplantation was decreased (mean 3.6％ vs.1.55％) and the proportion of NK cells increased (mean 3.3％ vs.11.5％).In the aGVHD mice treated with cyclosporine A,serum IL-10 expression level was significantly increased (treated group (125.79 ± 0.27)pg/mL,untreated group [(103.09 ± 3.27)pg/mL,P＜0.01)],TGF-β expression level was increased [(252.05 ±7.84)pg/mL vs.(241.61±15.41)pg/mL,P＞0.05],perforin expression level was significantly increased [(186.97 ± 4.68)pg/mL vs.(144.35 ± 14.42)pg/mL,P＜0.01].Conclusion ① The occurrence of aGVHD is correlated with the decreased number of Tree cells after transplantation in mice.Treg cell function-related cytokines IL-10 and TGF-β are involved in the treatment of aGVHD by cyclosporine A-mediated immunosuppression.②NK cells are involved in the occurrence of aGVHD after allogeneic bone marrow transplantation,and the increased level of perforin is related to the inhibition of aGVHD.
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Objective To explore the effect of transcription factor SOX18 on proliferation, migration and invasion of HeLa cells and its related mechanism. Methods HeLa cells were divided into blank control group, negative control group, pCI-SOX18 group. The expression of SOX18 and matrix metalloproteinase 7 (MMP-7) was detected by Western blot. The cell proliferation of different group was measured by MTT analysis. The effect of transcription factor SOX18 on migration and invasion of HeLa cells were measured by Transwell assay. Results HeLa cells were successfully transfected with pCI-SOX18. According to the results of MTT analysis, the cell number of pCI-SOX18 group showed no significant difference compared with blank control group and negative control group (P> 0.05). Compared to blank control group (0.23 ±0.05) and negative control group (0.28±0.07), SOX18 expression in pCI-SOX18 group (1.16±0.13) was significantly higher (F=218.14, P<0.05). Meanwhile, MMP-7 expression in pCI-SOX18 group (0.95±0.09) was increased significantly compared with blank control group (0.71±0.07) and negative control group (0.68±0.06) (F=116.84, P < 0.05). The number of cell migration in pCI-SOX18 group (175.71 ±17.17) was increased significantly compared with that in negative control group (95.19 ±8.18) and that in blank control group (93.34±9.72) (t=75.47, t=77.35, P<0.05). Compared with that in negative control group (98.63±14.62) and that in blank control group (96.57 ±13.95), the number of cell invasion in pCI-SOX18 group (247.12 ±36.82) was significantly higher (t=98.02, t=99.34, P<0.05). Conclusion Overexpression of SOX18 has no effect on the proliferation of HeLa cells, but has a significant role in promoting cell migration and invasion probably by regulating MMP-7 expression positively.
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Objective To explore the clinical application and value of percutaneous transhepatic gallbladder drainage (PTGD)under CT guide in high-risk emergency.Methods In all 57 old patients with high-risk acute cholecystitis in emergency,cuff-PTGD in 39 was performed and fractional step PTGD in 18 was also used.Results PTGD was successfully in all patients.After PTGD,except for 1 patient died of severe cardiac insufficiency,the abdominal pain and fever were alleviated during 72 hours,and the complications was not demonstrated.Conclusion As a safe,noninvasive and accurate method,CT-guided PTGD may relieve symptoms quickly,reduce the mortality and improve the treatment for some old patients with high risk acute cholecystitis.
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Objective To discuss the method and clinical effect of bilobed DIEP flap for repair of degloving injuries of the hand.Methods From June, 2013 to January, 2015, the bilobed DIEP flap were designed to repair 6 cases of degloving injuries of hand, of which the small leaf flap repaired separately defect of thumb, larger leaf flap repair 2nd-5th finger and palm and dorsum.The bilobed DIEP flap design were based upon anatomic study on deep inferior epigastric artery, superior epigastric artery, intercostal artery and its anastomosis.Results The largest area of main flap was 35 cm × 12 cm, and the deputy leaves of flap was 10 cm× 7 cm.All of the 6 flaps survived.One of them experienced distal end necrosis of epidermis.But it was healed by dressing changes.All of the 6 cases were followed up for average of 12 months (range, 6-20 months).All flaps were seen with good appearance, fully recovered protectve sensation and the active motion of the thumb was recovery.Moreover, the donor sites were closed directly and the appearance were satisfactory.Conclusion The bilobed DIEP flap is a satisfying choice in repairing degloving injuries of the hand in that it has reliable blood supply, can obtain the larger area of skin and leaves small injuries in targeted area.
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<p><b>OBJECTIVE</b>To explore the predictive value of high-sensitivity C reactive protein (hsCRP) in middle-aged population during the peripheral arteriosclerosis.</p><p><b>METHODS</b>Random sampling method was used in the study. In 2006-2007 Kailuan Group health examination of 101,510 employees, using stratified random sampling method to select 5,852 as observational cohort included, in the final with a standard queue 5,440 in December 2009. This study selected to participate in the 2012-2013 health examination cohort as the research object, in accordance with the inclusion criteria ultimately selected survey 3,978, select the epidemiological investigation, physical examination, laboratory testing data analysis. Of the 3 978 subjects, 2,282 were male and 1,696 were female, and the baseline age was (53.80±11.14) years. According to the baseline hsCRP quartile level was divided into four groups for comparison of baseline data, using multiple linear regression analysis between hsCRP and brachial-ankle pulse wave velocity (baPWV). Area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the prediction of hsCRP levels in peripheral arteriosclerosis.</p><p><b>RESULTS</b>With increase of hsCRP levels, the survey of baseline levels of baPWV showed increasing trend, (1,445.49±300.55), (1,494.46±307.94), (1,547.67±320.34), (1,621.32±342.53) cm/s, respectively. Multiple linear regression results showed that age, by logarithmic transformation of hsCRP (lghsCRP) level, systolic blood pressure and fasting blood glucose for each additional unit, baPWV levels were increased 266.47, 58.00, 5.02, 39.79 cm/s (P<0.001), and BMI for each additional unit, baPWV level decreased 9.52 cm/s (P=0.030). The prediction of hsCRP in peripheral artery showed that lghsCRP level of AUC to 0.59 (95% CI: 0.57-0.61), lower than the age and systolic blood pressure predicted value AUC (95% CI) of 0.69 (0.67-0.71), 0.75 (0.73-0.77), respectively.</p><p><b>CONCLUSION</b>The hsCRP level could not predict the peripheral arteriosclerosis alone, and the combined age and systolic blood pressure level could have better predictive value.</p>
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Female , Humans , Male , Middle Aged , Ankle , Ankle Brachial Index , Biomarkers , Blood Flow Velocity , Blood Pressure , C-Reactive Protein , Peripheral Arterial Disease , Pulsatile FlowABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effect of lateral superior genicular composite tissue flap for tissue defect.</p><p><b>METHODS</b>The axis line of flap is the lateral thigh vertical midline. The cutaneous branch is inserted 4 cm near the femoral lateral epicondylus. The anterior border is the elongation line along patellar lateral border. The posterior margin is the hinder margin of femoral biceps. The lower border is the horizontal line along the upper line of patella. The composite flaps were used in 18 cases with soft tissue defects in extremities, 11 cases with clacaneus tenden defects and 16 cases with bony nonunion. Results From Mar. 2002 to Sept. 2013, 45 cases were treated with the composite tissue flaps. The flaps size ranged from 6 cm x 3 cm to 17cm x 9 cm. All the flaps survived completely. Blood supply crisis happened in 2 cases, which was released by reanastomosis. The patients were followed up for 1 - 2. 5 years with satisfactory aesthetic and functional results. All the bone defect and nonunion were healed. Good healing was also achieved in donor sites. 8 months after operation, knee joint function is evaluated as good by hospital special surgery knee score (HSS).</p><p><b>CONCLUSION</b>Lateral superior genicular compostie tissue flap can be used to reconstruct soft tissue defect, bone defect and tenden calcaneus defect in one stage.</p>
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Humans , Anatomic Landmarks , Follow-Up Studies , Graft Survival , Knee , Muscle, Skeletal , Soft Tissue Injuries , Pathology , General Surgery , Surgical Flaps , Transplantation , Thigh , Time Factors , Wound HealingABSTRACT
Objective To evaluate the effect of try psin on the proliferation,migration and adhesion of a skin squamous cell carcinoma cell line A431.Methods Cultured A431 cells were divided into several experimental groups treated with trypsin at concentrations of 0.1,1,10 and 100 nmol/L for 24,48 and 72 hours respectively,and a control group treated with DMEM complete medium only.Cell counting kit-8 (CCK8) assay was conducted to evaluate cellular proliferative activity to select the optimal concentration of trypsin.Then,some A431 cells treated with trypsin at the selected concentration for 24,48 and 72 hours respectively (or 48 hours only) served as the experimental groups (or group),and other A431 cells treated with DMEM complete medium served as the control group.Flow cytometry was performed to assess cell cycle distribution and proliferation index,fibronectin-based adhesion assay to estimate cell adhesive capacity,and wound healing assay and Transwell assay were conducted to evaluate the migratory capacity of cells in two-and three-dimensional space.Statistical analysis was carried out by using analysis of variance,paired samples t test and chi-square test.Results The proliferative activity of A431 cells increased along with the increase of trypsin concentrations,with the strongest increasing effect observed at 100 nmol/L.After treatment with 100 nmol/L trypsin,the experimental group showed a decrease in the percentage of G1-phase cells,but an increase in the percentage of S-phase cells,proliferation index,migratory and adhesive capacity compared with the control group (all P ＜ 0.05).Conclusion Trypsin can promote the proliferation,migration and adhesion of A431 cells.
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Objective To explore and analyze effect of heparin combined with urokinase therapy on lower limb venous thrombosis.Methods 90 cases with lower extremity venous thrombosis were chosed and divided into control group of 45 cases and experimental group of 45 cases according with random number table method.Control group was given pure low molecular heparin treatment, experimental group was treated with small dose of urokinase static drop on the basis of control group, 7 days for a course, a total of 2 course of treatment.Compared two groups before and after treatment of lower limb venous patency rate changes, blood coagulation function index, adverse reactions and the recurrence rate.Results Compared with control group post-treatment.patency rate of posterior divisions, popliteal vein and posterior tibial vein of experimental group were significantly better (P<0.05).Experimental group post-treatment compared with control group post-treatment, PT, APTT, TT time had significant difference ( P <0.05 ).Patients incidence of adverse reactions were significantly lower than control group ( P <0.05 ).Patients were followed up for 1 year recurrence rate was significantly lower than control group ( P <0.05 ).Conclusion Effect of low molecular heparin combined with urokinase in the treatment of venous thrombosis of lower limbs significant and its prognosis is well.
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<p><b>OBJECTIVE</b>To investigate the therapeutic effect of primary reconstruction of skin avulsion injury with bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.</p><p><b>METHODS</b>From June 2005 to Aug. 2011, 4 cases with skin avulsion injury on both feet were treated. The bilateral anterolateral thigh flaps, including with anterolateral thigh cutaneous nerves, were transferred to cover the feet plantar. The thorax umbilicus flap or latissimus dorsi flap were used to cover the feet dorsum.</p><p><b>RESULTS</b>All the skin avulsion injury were reconstructed primarily. All the flaps survived completely with good cosmetic and functional results. The patients were followed up for 6 months to 2 years with good sensory recovery (two point discrimination: 14-18 mm).</p><p><b>CONCLUSION</b>The skin avulsion injury on both feet can be primarily reconstructed by bilateral anterolateral thigh flaps combined with thorax umbilicus flap or latissimus dorsi flap.</p>