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Objective:To compare the clinical effect of perforator flap of proper palmar digital and hallex fibular flap in repair of soft tissue defect of fingers.Methods:A total of 52 patients with finger soft tissue injury were reviewed from January, 2017 to January, 2019. Twenty-seven patients were repaired by perforator flap of proper palmar digital artery, and 25 by hallex fibular flaps. Both groups of patients had only soft tissue defects without phalangeal fracture. Postoperative follow-up were conducted by phone, WeChat and visit of outpatient clinic. The recovery of finger sensory function was evaluated according to the Trial Standard for Replantation Evaluation of Severed Digit by the Hand Surgery Society of Chinese Medical Association. The flaps were evaluated according to the shape, patient satisfaction and finger function and classified in excellent, good, fair and poor. Data of the 2 groups of patients were collected and statistically analysed by SPSS 22.0. P<0.05 was statistically significant. Results:Both groups entered follow-up for 12-16 months. All flaps in both groups survived. There was statistically significant difference of TPD between the 2 groups[TPD were 4-7(5.3±1.2) mm and 6-10(8.4±1.7)mm, respectively]( t=7.642, P=0.000). According to the Evaluation Criteria of the Hand Surgery Society of the Chinese Medical Association. In the group repaired by perforator flap of proper palmar digital artery, 17 fingers were excellent, 6 good, and 4 fair, with a 85.1% of excellent and good rate. In the group repaired by hallex fibular flap, 8 fingers were excellent, 5 good, 9 fair, and 3 poor, with a 52.0% of excellent and good rate. The difference between 2 groups was statistically significant ( t=6.710, P=0.009). There was a 3.7% incidence of complications in the group repaired by perforator flap of proper palmar digital artery, and 25.9% in the group repaired by hallex fibular flap. The difference between the 2 groups was statistically significant( t=4.167, P=0.032), and there was a higher incidence of complications in the group repaired by hallex fibular flap. Conclusion:The perforator flap of proper palmar digital artery and the hallex fibular flap are good choices in the repair of finger soft tissue defect. However, the postoperative complication of the hallux fibular flap is relatively high. Therefore, it is necessary to make a decision in the choice of flap according to the actual situation in clinical work.
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Objective To observe any short-term analgesic effect of using heat stimulation at acupoints for treating migraine headaches without aura.Methods Totally 120 migraine patients were randomly divided into an observation group and a control group,each of 60.Both groups was given 5mg of Sibelium orally each night for 4 weeks.The observation group additionally received heat and pain stimulation at the Feng Chi,Shuai Gu,Yang Ling Quan,Wai Guan,Tai Yang and Yin Tang acupoints.The heat was in 0.3 s pulses at 54.5° with an inter-pulse interval of 10 s.Each acupuncture point was stimulated 5 times in rotation for a total of 20 min daily for 4 weeks.The frequency of headache attacks,their duration,their intensity rated using a visual analogue scale (VAS),accompanying symptoms and responses to a migraine-specific quality of life questionnaire (MSQ) were recorded before and after the treatment.Results After the treatment there was significantly greater improvement in the observation group compared to the control group in terms of headache frequency,headache duration,VAS ratings,and accompanying symptoms.The observation group also improved significantly more in terms of the average limitation dysfunction score,dysfunction score and emotion score on the MSQ.Moreover,the total effectiveness rate of the observation group (95.0％) was significantly higher than that of the control group (80.0％).During the treatment,no adverse reactions were found in terms of heart rate or blood pressure,and no abnormal manifestations such as infection,redness or swelling were observed at the stimulation sites.Conclusion Heat and pain stimulation at acupoints has a significant short-term analgesic effect on migraine without aura.Such treatment is safe and reliable,with few side effects.It provides a new treatment method for migraine patients and is worthy of clinical promotion and application.
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Objective To investigate the design,incisional method and clinical experiences of using the mi cro-dissected polyfoliate anterolateral thigh perforator flap to repair of complex soft tissue defect in extremities.Methods From June,2017 to September,2018,12 cases of different kinds of complex soft tissue defect in extremities were repaired by micro-dissected free polyfoliate anterolateral thigh perforator flap.Each flap was divided into two cutaneous perforators to give two separate flap with a common vascular supply.The flaps were cut from the superficial layer of the deep cervical fesciae and without fascia lata.The donor sites were treated by subcutaneous cosmetic suture.Patients were followed-up by outpatient service,telephone and WeChat video to observe and record the flap's appearance,sensory recovery,extremities function and the scars of the donor site to evaluate its clinical efficacy.Results All flaps survived without vascular crisis happened except one-leaf necrosis occurred,which healed with local flap transferring.The donor sites remained linear scars.The mean flap thickness of this group after micro-dissection was (4.5±0.5) mm.All the patients were followed-up for 5-15 months.The 2 point discrimination ranged between 0.5-2.0 cm.Sensory restoration ranking was S3-S3+.The range of montion of wrist joint was 65°-90°,and that of ankle joint was 40°-60°.Conclusion The micro-dissected polyfoliate anterolateral thigh perforator flap is an ideal method for complex and irregular multiple sites soft tissue defect in extremities as it can keep good economic benefit and minimal damage to the donor site.
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Objective To establish a stable experimental model of vascularized composite allograft (VCA),which would facilitate us to study of the reaction and intervening measure regarding rejection reaction in the future.Methods From September,2016 to July,2017,30 healthy male New Zealand rabbits,weighted 2.5-3.0 kg each,were chosen.Their ears should be intact without defect or necrosis.All of them were randomly and eaqually divided into 2 groups:transverse amputated group and V-shaped amputated group.In situ ear replantation after the amputation was performed.Histology analysis of skin and cartilage were done through HE and TUNEL staining,in order to compare vital rate of these ears.Results Thirty rabbits underwent ear replantation,including 13 via transverse incision and 17 via V-shaped incision.In transverse group,no ear survived,and some of them encountered vein crisis gradually after operation.The survival time ranged from 1 day to 10 days.There were 2 ears survived in V-shaped group.From HE staining,it was found certain vacuolar degenerated cells within skin and cartilage in failure ears.The rates of cell necrosis and apoptosis were higher than the survived ears.Conclusion Rabbit ear replantation model is viable.However,the rabbit ear replantation model is not suitable to be used in large samples.
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Objective To explore the curative effects of unilateral Orthofix external fixation in the treatment of tibial defects.Methods From June 2012 to February 2016,we treated 19 patients with tibial defects using unilateral Orthofix external fixation.They were 14 men and 5 women,aged from 26 to 79 years (mean,43.0 years).The right tibia was involved in 12 cases and the left tibia in 7.The soft tissue defects averaged 6.4 cm × 3.7 cm.The mean bone defect before bone transport was 8.9 cm in length.The anteroposterior and lateral X-ray films of the affected tibia were taken regularly after surgery.Edwards tibial fracture scores were used to evaluate the functional recovery and complications of the affected limb at final follow-ups.Results All the patients were followed up for 10 to 40 months (average,18.5 months).Bone union time ranged from 4 to 16 months (average,9.0 months).Lengths of bone transport ranged from 6 to 10 cm (average,7.8 cm).All the bone defects were reconstructed.According to the Edwards scoring at the final follow-ups,10 cases were rated as excellent,6 as good and 3 as poor.Complications were observed in 4 cases,giving a complication rate of 21.1％.Conclusion Unilateral Orthofix external fixation and bone transport can lead to preferable curative effects in the management of tibial defects.
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Objective To summarize the clinical experience of laparoscopic appendectomy(LA).MethodsA retrospective analysis was conducted on the clinical data of 683 patients with appendicitis treated by LA,including 258 cases of chronic appendicitis,425 cases of acute appendicitis(87 cases of complicated appendicitis).ResultsThe procedure was completed in all the patients without conversion to open surgery.The operation time was 30 min in average(15-150 min).The average hospital stay was 4d (2-15d).Postoperative complications included 26 cases of incision infection,3 cases of abdominal abscess,1 case of appendical mesenterium hemorrhage,1 case of small intestine fistula and 1 case of appendical stump fistula.The patients were followed up for 2 to 12 months with a mean of 6 months,during which no intestinal adhesive obstruction occurred.Conclusion LA is safe and effective for appendicitis,with advantages of minimal trauma,lighter pain,quicker recovery,shoter hospital stay,less complications and so on.For complicated appendicitis,the abundant surgical experience and proficient endoscopic technique are indispensable to reduce the occurrence of complications effectively.
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Objective To study the drifting law of floats and potential risks of Oncomelania hupensis diffusion in the water diversion rivers of the east route of South?to?North Water Diversion Project. Methods The O. hupensis snails in the river chan?nels were monitored by the salvage method and snail luring method with rice straw curtains,and the diffusion possibility of snails along with water was assessed through the drift test of floats with GPS. Results In the flood seasons from 2006 to 2013, totally 8 338.0 kg of floats were salvaged,and 2 100 rice straw curtains were put into water in the Li Canal and Jinbao shipping channel,but no Oncomelania snails were found. The drift test of floats with GPS before water diversion showed that the flow ve?locity on water surface(northbound)was 0.45 m/s,the average drift velocity of the floats was 0.56-0.60 m/s,and the average drift distances each time were 999.70- 1 995.50 m in the Gaoshui River section,while there were no obvious drift in Jinbao shipping channel section. During the water diversion period,the flow velocity on water surface(northbound)was 0.45 m/s,the average drift velocity of the floats was 0.35-0.41m/s,and the average drift distances each time were 1 248.06-1 289.44 m in the Gaoshui River,while in Jinbao shipping channel section,the flow velocity on water surface was 0.28 m/s,the average drift velocity of the floats was 0.25- 0.27 m/s,and the average drift distances each time were 477.76- 496.38 m. The drift test showed that the floats gradually closed to the river bank as affected by water flow,wind direction and ship waves,when blocked by the reeds,water plants or other obstacles,and they would stopped and could not continue to drift without outside help. Con?clusions There are no Oncomelania snails found in the river channels of the east route of South?to?North Water Diversion Proj?ect. The drifting distance of the floating debris along with the water is restricted by the flow rate and shore environment.
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Objective To investigate the renal expression changes of microRNA-215(miR-215) and its role in diabetic nephmpathy of type 2 diabetic db/db mice. Methods Fourweek-old diabetic db/db mice and norml control group non-diabetic db/m mice were selected.Real-time PCR was used to detect the relative level of miR-215 at the age of 8,12 and 16 weeks.Catenin beta interacting protein 1 (CTNNBIP1) mRNA and protein level were measured by realtime PCR,WesteRN blotting and immunohistochemisty.A lueiferase reporter assay was used to determine whether CTNNBIP1 was a direct target of miR-215. Results (1)With the growth of db/db mice,the major pathological characteristics of kidney included glomerular hypertrophy,segmental mesangial cells proliferation and mesangial matrix expansion.(2)Compared with the db/m mice,the db/db mice of 8,12 and 16 weeks showed obvious increase in body weight(BW),blood glucose (Glu) and 24 hour urinary albumin excretion (UAE) (P＜0.05,respectively).(3)Compared with the db/m mice,special miR-215 was highly expressed in the kidney of db/db mice and was up-regulated significantly according to the development of DN (P＜0.05).(4)The mRNA and protein expression of CTNNBIPl of kidney were consistently down-regulated in db/db mice than those in controls (P＜0.05,respectively). (5)By luciferase reporter,miR-215 could negatively regulate CTNNBIP1 gene by targeting its 3'-UTR sequence (P＜0.01). Conclusion High expression level of miR-215 plays a potential role in the initiation and progression of DN by down-regulating the expression of CTNNBIPl.
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Objective To study the effects of eliminating free radical and increasing antioxidative capacity of glutathione peroxidase 1(GPX1) on PC12 cells. MethodsGPX1 recombinant plasmid and Plncxplasmid were transfected into PC12 cells and PC12 cells highly-expressing GPX1 stably were sieved by G418 solution. PC12 ceils were treated with different concentrations of amyloid β-protein (Aβ25-35) for 48 h, to decide the optimal concentration of Aβ25-35 and construct ideal cell model. GPX1/pLNCX/PC12 group, pLNCX/ PC12 group and PC12 group were treated with optimal concentration of Aβ25-35 ,respectively for 48 h, and their absorbance (A) value by MTT conversion was compared among three groups.ResultsCell clone highly expressing GPX1 stably were obtained by G418 selection. The increment of cell inhibition ratio was 24.7 ％ after 20 μmol/L Aβ25-35 treatment for 48 h, compared with control group (P＜0.01). Thus the optimization concentration of Aβ25-35 was 20 μmol/L. After treatment with 20 μmol/L for 48 h, the A value was significantly higher in GPX1/pLNCX/PC12 group than in pLNCX/ PC12 group and in PC12 cells group(0.53±0. 02 vs. 0.44±0.02;0.53±0.02 vs. 0.39±0.07, P＜0.01). Conclusions Transfection of GPX1 recombinant plasmid may protect cell against injury from free radical and reverse the decrease of PC12 cell survival rate impaired by Aβ25-35.
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Objective To investigate the application valve of bFGF to improve the viability of trans-plantation flap in Wistar rat. Methods Forty-eight Wistar rats were randomly divided into two groups based on the age: group A,B(1.5 month old, every group was 12 rats) and group C,D (3 month old, every group was 12 rats). After an ischemic model completed, recombinant bovine basic fibroblast growth factor (rb-bFGF) was given to groups A and C in ischemie zone by vascularization flap injection and the equality of normal saline to groups B and D. 14 days postoperatively, the muscular tissue was sent for histology, the blood vessel density was calculated by image analysis, and positive VEGF was detected by immunohistochem-istry. Results The member of capillaries and positive VEGF were more in group A than that in B, and also were morein group C than D(P < 0.05), but there were not statistic difference between group A and C (P > 0.05). Conclusion Recombinant bovine bFGF can stimulate angiogenesis and improve the ischemie vascu-larization flap of rat, which is not associated with their age.
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This study developed a management information system for rural basic publication health. The system, which is convenient for management of public health information and can improve the efficiency, is suitable for management of rural basic public health at various health administration sections.
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Objective To discuss the clinical therapeutic efficacy of the clinical study of thumb tip defect reconstruction with free distal second toe in emergency. Methods Fifteen cases of thumb tip defect were reconstructed with free distal second toe in emergency.The blood supply was restored by anastomosis of digital and toe'S artery and nerves,the dorsal surface and other side vein of fingers all can be anastomosed with toe's vein.but the first was main. Results All of fifteen fingers survived.Followed-up from 3 months to 3 years,all reconstruction thumbs has a satisfying outward appearance,normal nail and fingerprint,well pinch and hold functions, none effect to the foot. Conclusion Repair of thumb tip defects using free distal second toe in emergency enables favorable functional recovery and satisfying outward appearance,the method is simple and rats recover quickly.
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0.05).There are significant statistical differences in NIHSS(91.3% vs 71.3%)and BI(93.8% vs 75.0%)between two groups af- ter treatment(P0.05). Conclusion Multidisciplinary integrated treatment mode is an effective treat ment for stoke.