Identification of Levisticum officinale Adulterated in Angelica sinensis by PCR-RFLP / 中国实验方剂学杂志

Objective:To establish a rapid method to identify <italic>Levisticum officinale </italic>adulterated in<italic> Angelica sinensis</italic> by polymerase chain reaction -restriction fragment length polymophism（PCR-RFLP）. Method:By comparing sequences restriction sites in ribosomal DNA Internal Transcribed Spacer（ITS） of <italic>A. sinensis</italic> and <italic>L. officinale</italic>，the specific restriction site Fnu4HI of <italic>L. officinale</italic> was selected，and the primers for PCR-RFLP reaction were designed. Different <italic>A. sinensis</italic> and <italic>L. officinale</italic> were amplified by PCR. The conditions affecting the PCR-RFLP reaction，such as annealing temperature，primer concentration，cycle number and enzyme digestion reaction time，were optimized，and the accuracy of the method was investigated. The established PCR-RFLP identification method was used to investigate the applicability of <italic>L. officinale </italic>adulterated<italic> in A. sinensis</italic> with different aduleration ratios and different origins. Result:A PCR-RFLP method for identifying <italic>A. sinensis</italic> mixed with <italic>L. officinale</italic> was established. When the annealing temperature was 62 ℃ and the number of cycles was 30，when the <italic>L. officinale </italic>adulterated in<italic> A. sinensis</italic> could be digested by Fnu4H I restriction endonuclease after amplification with specific primers，and the two single DNA bands were detected between 100-500 bp，the <italic>A. sinensis</italic> were all negative. The minimum detection limit of this method for adulterated <italic>L. officinale</italic> in <italic>A. sinensis</italic> was 3%，which could be used for the detection of adulterated <italic>L. officinale</italic> in <italic>A. sinensis</italic>. Conclusion:The established PCR-RFLP identification method is sensitive and accurate in detecting whether there is <italic>L. officinale</italic> in <italic>A. sinensis</italic>，and it provides inspection reference and basis for the quality control of <italic>A. sinensis</italic>，with great significance to ensure the safety of its clinical medication.

Identification of Armeniacae Semen Amarum Adulterated in Persicae Semen by Allele-specific Polymerase Chain Reaction / 中国实验方剂学杂志

Objective:Due to the limitation of traditional identification methods of Chinese medicinal materials， the study established a rapid method to identify Persicae Semen mixed with Armeniacae Semen Amarum by allele-specific polymerase chain reaction （PCR）. Method:By comparing the ribosomal DNA internal transcribed spacer （ITS） gene sequences of Persicae Semen and Armeniacae Semen Amarum， single nucleotide polymorphism （SNP） sites were searched and specific primers were designed. Different Persicae Semen and Armeniacae Semen Amarum samples were amplified by PCR， the effects of annealing temperature， primer concentration and cycle number on the PCR reaction system were optimized， and the specificity and detection limit of this method were investigated. In addition， the established PCR method was used to detect the samples of Persicae Semen mixed with different proportion of Armeniacae Semen Amarum from different sources and producing areas. Result:A specific PCR method for identifying Persicae Semen mixed with Armeniacae Semen Amarum was established. When the annealing temperature was 63 ℃ and the number of primer cycles was 30， only Armeniacae Semen Amarum could be amplified with 432 bp specific band， while Persicae Semen samples did not have this band. The minimum detection limit of this method for Armeniacae Semen Amarum was 0.2 ng， and the detection limit for Armeniacae Semen Amarum adulterated in Persicae Semen was 1%. Conclusion:The established allele-specific PCR method can accurately detect whether there is Armeniacae Semen Amarum in Persicae Semen， which can provide experimental basis for the quality control of Persicae Semen and guarantee the safety of its clinical use.

Analysis of Chemical Constituents in Violae Herba and Investigation of Its Antioxidant Activity in Vitro / 中国实验方剂学杂志

Objective:To investigate the chemical constituents and antioxidant activities of Violae Herba from the Violaceae. Method:The 5 kg of Violae Herba was refluxing extracted with 3 times the amount of 95% ethanol for three times， then the extracting solution was combined， filtrated， concentrated under vacuum to get the total extract. Seven corresponding fractions were eluted with petroleum ether， dichloromethane， dichloromethane-methanol （50∶1， 10∶1， 5∶1， 2∶1） and methanol by silica gel column chromatography （60-100 mesh） on the total extract. Each fraction was isolated and purified by normal phase silica gel column chromatography， octadecylsilane chemically bonded silica （ODS） column chromatography， Sephadex LH-20 column chromatography and preparative high performance liquid chromatography （HPLC）， respectively. The structures of the obtained compounds were identified by spectroscopic methods of nuclear magnetic resonance （NMR）， mass spectroscopy （MS） and infrared spectroscopy （IR）. Meanwhile， some of these compounds isolated from Violae Herba were carried on the 1，1-diphenyl-2-picrylhydrazyl （DPPH） free radical scavenging experiment. Result:Fourteen compounds were isolated from the 95% ethanol extract of Violae Herba， including <italic>N</italic>-acetyl-1-ethyl ester glutamic acid （<bold>1</bold>）， <italic>N</italic>-acetyl glutamic acid-1-ethyl-5-methyl ester （<bold>2</bold>）， aurantiamide （<bold>3</bold>）， <italic>rel</italic>-（2<italic>α</italic>，3<italic>β</italic>）-7-<italic>O</italic>-methylcedrusin （<bold>4</bold>）， oleanolic acid （<bold>5</bold>）， <italic>α</italic>-tocopherol-quinone （<bold>6</bold>）， tectochrysin （<bold>7</bold>）， isoscopoletin （<bold>8</bold>）， esculetin （<bold>9</bold>）， 24-ethylcholesta-4，24（28）<italic>Z</italic>-dien-3-one （<bold>10</bold>）， stigmasta-4，25-dien-3-one （<bold>11</bold>）， <italic>β</italic>-sitostenone （<bold>12</bold>）， <italic>β</italic>-sitosterol （<bold>13</bold>）， （24<italic>R</italic>）-3<italic>β</italic>-hydroxy-ethylcholest-5-en-7-one （<bold>14</bold>）. Conclusion:Compound <bold>2</bold> is a new natural product， compounds <bold>1</bold>， <bold>4</bold>， <bold>6</bold>， <bold>7</bold>， <bold>10</bold>-<bold>12 </bold>are isolated from the genus <italic>Viola</italic> for the first time. Compound <bold>9</bold> has significant antioxidant activity， while compounds <bold>2</bold>， <bold>6 </bold>and<bold> 8</bold> have certain DPPH free radical scavenging activity.

Trend of premature birth in Shaoxing from 2007 to 2018 / 预防医学

Objective@#To explore the prevalence and trend of premature delivery in Shaoxing Maternal and Child Health Care Hospital from 2007 to 2018, so as to provide evidence for prevention of premature birth and promotion of perinatal health care. @*Methods@#The data of live births in Shaoxing Maternal and Child Health Care Hospital from 2007 to 2018 were collected,and premature birth rate,proportion of premature infants in different gestational weeks,as well as the trend of gender ratio,asphyxia and birth weight with gestational weeks were analyzed.@*Results@#From 2007 to 2018,there were 10 506 premature infants born in Shaoxing Maternal and Child Health Care Hospital. The preterm birth rate increased year by year （P<0.05）,and the annual average was 9.09%. The rate of multiple premature birth was 57.80%,which was higher than that of single premature birth （7.26%,P<0.05）. There were 110 cases of extremely preterm birth （1.05%）,2 997 cases of early preterm birth （28.53%）,and 7 399 cases of mild preterm birth （70.43%）. The proportions of extremely and early preterm birth increased year by year （P<0.05）. The asphyxia rate of premature infants was 9.70% （1 019 cases）,which decreased with the increase of gestational weeks （P<0.05）. The birth weight of premature infants decreased with the increase of gestational weeks （P<0.05）. The ratio of male to female in preterm infants was 1.22∶1,which was higher than 1.10∶1 in term infants （P<0.05）.@*Conclusion@#From 2007 to 2018,the preterm birth rate of Shaoxing Maternal and Child Health Care Hospital increased year by year,especially in extremely and early preterm birth.

Chemical Constituents from Stems of Zanthoxylum bungeanum / 中国实验方剂学杂志

Objective::To isolate and identify the chemical constituents from the 95%, 75%ethanol extracts of the stems of Zanthoxylum bungeanum. Method::The 25 kg stems of Z. bungeanum were extracted with 95%, 75%ethanol for three times, and the combined filtrates were concentrated under vacuum to get the extracts. The 95%extracts were then extracted by petroleum ether, dichloromethane, ethyl acetate and n-butanol successively to obtain corresponding fractions. Such fractions and 75%extracts were isolated and purified by silicagel, Sephadex LH-20, ODS, preparation HPLC and recrystallization to obtain compounds. Their structures were identified by mass spectroscopy (MS), and nuclear magnetic resonance (NMR). Result::Sixteen compounds were isolated from the stems of Z. bungeanum and identified as dictamnine(1), decarine(2), zanthobungeanine(3), pseudocolumbamine(4), skimmianine(5), norchelerythrine(6), osthenol(7), dimethylfraxetin(8), 3, 4, 5-trimethoxycinnamylalcohol(9), asarinin(10), yangambin(11), syringaresinol(12), ashantin(13), bis(2-ethylhexyl) benzene-1, 2-dicarboxylate(14), 24-propylcholesterol(15), and sucrose(16). Conclusion::Compounds pseudocolumbamine(4), 3, 4, 5-trimethoxycinnamylalcohol(9), and 24-propylcholesterol(15)were isolated from the genus of Zanthoxylum for the first time and compounds dictamnine(1), osthenol(7), dimethylfraxetin(8), asarinin(10), yangambin(11), syringaresinol(12), ashantin(13), and bis(2-ethylhexyl) benzene-1, 2-dicarboxylate(14)were isolated from this plant for the first time.

Isolation and Identification of Chemical Constituents from Paeonia veitchii / 中国实验方剂学杂志

Objective::To investigate the chemical constituents from Paeonia veitchii. Method::P. veitchii samples (30 kg) were extracted with 95% ethanol for four times and then filtrated, and the combined filtrates were concentrated under vacuum to get the extracts. After suspension with water, exaction was conducted with petroleum ether, dichloromethane, ethyl acetate, n-butanol and water successively to obtain five corresponding fractions. The compounds were isolated and purified by silica gel, Sephadex LH-20, ODS column chromatography and prep-HPLC, and the structures of these compounds were determined by such spectrum technologies as infrared spectroscopy (IR), mass spectroscopy (MS), and nuclear magnetic resonance (NMR). Result::Sixteen compounds were isolated and their structures were identified as follows (1S, 5R, 6R)-1, 8-dihydroxypin-2-en-4-one (1), (2-hydroxyl)-phenyl-methyl-β-D-xylopyranoside (2), flufuran (3), 6′-O-vanillylpaeoniflorin (4), methyl 2, 5-dihydroxycinnamate (5), (1S, 2S, 5R, 6R)-1, 8-dihydroxypin-4-one (6), palbinone (7), 4-O-methylpaeoniflorin (8), 4-O-ethylpaeoniflorin (9), benzoyloxypaeoniflorin (10), benzoic acid (11), gallic acid (12), methyl gallate (13), ethyl gallate (14), β-sitosterol (15), and 1, 2, 3, 4, 6-penta-O-galloyl-β-D-glucopyranose (16). Conclusion::Compounds 1, 2 were new natural compounds; compound 3 was isolated from genus Paeonia for the first time, and compounds 4-7 were isolated from this plant for the first time.

Chemical Constituents from Stems of Zanthoxylum bungeanum / 中国实验方剂学杂志

Objective:To isolate and identify the chemical constituents from 95%ethanol extracts from stems of Zanthoxylum bungeanum. Method:The stems (25 kg) were extracted with 95%ethanol under reflux for three times and then filtrated,and the combined filtrates were concentrated under vacuum to get the extracts. After suspension with water,the extracts were extracted with petroleum ether,dichloromethane,ethyl acetate and n-butanol successively,and five corresponding parts were obtained. The parts of petroleum ether,dichloromethane,ethyl acetate were separated in a similar way to get pure compounds. By the method the subjects were first chromatographed on silica gel column respectively,then the selected sub-fractions were further separated by Sephadex LH-20, and finally purified on preparation HPLC to get the monomer compound. The n-butanol part was first treated with macroporous resin D101,and then the sub-fractions were further purified by almost the same method as mentioned above. The structures of these compounds were determined by spectrum technology as IR,MS,1H-NMR,13 C-NMR. Result:Ten compounds were isolated from Z. bungeanum stems and identified as follows:(+)-magnoflorine(1),(-)-marmesin(2),(-)-columbianetin(3),(-)-decursinol(4),lupeol(5),α-amyrin(6),β-amyrin(7),δ-amyrin(8),quercetin(9),rutin(10). Among them, 1 was alkaloid, 2,3,4 were coumarin, 5,6,7,8 were triterpenoid, 9,10 were flavonoids. Conclusion:Compounds 1-8 were isolated from this plant for the first time.

Treatment of lumbar disc herniation with modified transforaminal endoscopic surgical system / 中国内镜杂志

Objective To explore the clinical effects and influence factors in the treatment of lumbar disc herniation (LDH) by the application of modified transforaminal endoscopic surgical system. Methods Clinical data of 178 cases with LDH from November 2013 to May 2016 was retrospectively analyzed and totally followed-up after surgery. Compare the scores of VAS and JOA preoperative and in the follow-up, the efficacy evaluation was performed using modified MacNab system, the effectiveness was observed and the factors that might affect the efficacy were analyzed. Results The VAS score in the back pain, leg pain and JOA of lumbar vertebral function, those three indexes were significantly improved (P < 0.01). Modified MacNab system: 57 cases in excellent, 85 cases in good, 20 cases in fair and 16 cases in poor, with an excellent and good rate of 79.8% and 91.0% efficiency; The results of single factor analysis showed that there was a correlation between age, course of disease, history of surgery in the same segment, symptoms and calcification of prolapse objects (P < 0.05). The results of multi-factor analysis showed that age above 45 years old, history of surgery in the same segment and numbness were the independent risk factors (OR

Effects of Baltimore Therapeutic Equipment on Traumatic Upper Extremity Injury from Work / 中国康复理论与实践

Objective To apply the Baltimore Therapeutic Equipment (BTE), a kind of vocational training and evaluation system, in rehabilitaion of patients post traumatic upper extremity injury from work, and to observe the effects. Methods Inpatients from September, 2014 to August, 2015 for rehabilitation of traumatic upper extremity injury from work were selected as control group (n=42), and inpatients from September, 2015 to August, 2016 were selected as intervention group (n=36). Both groups received routine rehabilitation, while the control group received con-ventional work simulation training, and the intervention group received work simulation training with BTE, for four weeks. They were measured the standing lifting strength (elbow), squatting lifting strength, dynamic lifting strength (floor to waist), dynamic lifting strength (floor to shoulder), and grip strength of the injured hand and the healthy hand with BTE, before and after rehabilitation; while they were assessed with Disability of Arm Shoul-der and Hand (DASH). The incidence of return to work was investigated at six months of follow-up. Results The standing lifting strength (elbow) (t=4.290, P<0.001), squatting lifting strength (t=2.645, P=0.010), dynamic lifting strength (floor to waist) (t=2.639, P=0.010), dynamic lifting strength (floor to shoulder) (t=5.361, P<0.001), and grip strength of the injured hand (t=2.320, P=0.023) and the healthy hand (t=3.130, P=0.002) im-proved better in the intervention group than in the control group after rehabilitation. However, there was no sig-nificant difference between two groups in score of DASH (t=-0.851, P=0.398), as well as incidence of return to work (χ2=0.05, P=0.944). Conclusion BTE may help to improve the body function in patients post traumatic upper extremity injury from work. However, vocational rehabilitation should focus on the factors other than body function, to improve their return to work.

Anti-aging effect and mechanism of concentrated solution of aqueous extract form Penthorum chinense / 中草药

Objective: To observe anti-aging effect and mechanism of concentrated solution of aqueous extract from Penthorum chinense. Methods: Aging mice models were caused by D-galactose, learning and memory functions were investigated by avoid dark experiment, the spleen index, activity of MAO in liver, activities of SOD and MDA in serum were recorded, and the expression of p21 and p53 protein was detected by Western blotting. Results: Concentrated solution of P. chinense by aqueous extraction increased the ability of learning and memory, improved spleen index and activity of SOD in serum, but it decreased the activity of MDA in serum and the activity of MAO in liver, and inhibited p21 and p53 protein expression in a dose-dependent manner. Conclusion: Concentrated solution of aqueous extract from P. chinense could significantly exhibit anti-aging effects, its mechanism may be related to down-regulating the p53/p21 protein expression in aging signaling pathway, enhancing immune function, and removing free radicals.

A study on the immunity level of Neisseria meningitides serogroup W1 35 among healthy population / 预防医学

Objective To learn the immunity level of Neisseria meningitides (Nm) serogroup W1 35 among healthy population.Methods A total of 410 children aged 0 -14 years were selected by stratified random sampling method in Zhuji city.The polysaccharide antibody IgG level of Nm serogroup W1 35 was detected by ELISA.The antibody concentrations more than 2 μg/mL were identified as positive.Results The geometric mean concentration (GMC)was 1.46 ±0.25 μg/mL and the W1 35 -antibody positive rate was 4.63%.There was no difference on antibody GMC and the W1 35 -antibody postive rate among different region and gender groups.There were statistical differences on antibody GMC among different age groups (P<0.05).The antibody GMT in the age group 15 -34(1.63 ±0.28 μg/mL )was significantly higher than that in other age groups(P <0.05),and the antibody GMT in the age group 1.5 -4 (1.37 ±0.19 μg/mL)was significantly lower than that in the age group 5 -14 (P <0.05).The antibody GMT were significantly lower in the elderly (≥60 years old)than that in the age group <10 and 5 -14(P <0.05).Conclusion The immunity level of Nm serogroup W1 35 among healthy population is low,and it is suggested to be immunized by the vaccines which contained Nm W1 35.

Submental versus platysma flap for the reconstruction of complex facial defects following resection of head and neck tumors

To compare the platysma flap with submental flap in terms of tumor and flap characteristics, operative properties and the functional outcomes. A total of 65 patients presented with tumors of head and neck and underwent curative tumor resection with different neck dissections at the Department of Oromaxillofacial-Head and Neck Surgery, School of Stomatology of China Medical University; from March 2005 to December 2012 were included in the study. After radical tumor excision and neck dissection the resultant complex defects were reconstructed with either platysma flap or the submental flap. The extent of surgical resection, the type of neck dissection and choice of flap reconstruction was at the discretion of the surgical team. The functional outcomes, operative time and characteristics of both platysma and submental flaps were compared and the statistical tests of significance were applied accordingly. The mean age was 60 years. The complex facial defects of 30 patients were reconstructed with platysma flap and of 35 patients with submental flap. Mean operation time of submental flap including flap harvesting [5.58 +/- 1.96hrs] was shorter than platysma flap [6.2 +/- 1.4hrs]. The majority of the flaps [88-93%] were taken successfully in both groups. Submental flap was associated with significantly higher patients' satisfaction regarding acceptable functional outcomes [p-value 0.027]. The mean reduction in mouth opening was significantly smaller in platysma group [0.37 +/- 0.18cms] than the submental group [0.47 +/- 0.16]. This study demonstrates that both platysma and submental flap techniques can be used for the reconstruction of complex facial defects with the acceptable functional outcome. The platysma flap can be harvested to medium size defects up to 70cm2 with good mouth opening. The submental flap is simpler, faster with a wider range of application and more acceptable functional outcomes

Assessment of quality of life of oral cancer patients after reconstruction with radial forearm free flaps / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the quality of life in patients who had resection of oral cancer and reconstruction by radial forearm free flaps.</p><p><b>METHODS</b>Quality of life of 49 patients was assessed by means of the 14-item oral health impact profile (OHIP-14) and the medical outcomes study-short form-36 (SF-36) questionnaires 12 months after operation.</p><p><b>RESULTS</b>Forty-one questionnaires were collected (84%). SF-36: the highest-scoring domain were physical role (92.9 ± 2.6) and bodily pain (82.6 ± 5.7), the lowest-scoring domain were vitality (61.5 ± 9.1), followed by role emotion (64.9 ± 6.8) and social functioning (65.2 ± 8.2). OHIP-14: the best-scoring domain were handicap (37.1 ± 15.1) and psychological disability (45.7 ± 11.9), the best-scoring domain were physical pain (64.2 ± 11.7) and functional limitation (61.9 ± 12.9).</p><p><b>CONCLUSIONS</b>Radial forearm free flaps for reconstruction of oral defects after cancer resection could significantly influence the patients' quality of life.</p>

Complete nucleotide sequence of a human coxsackievirus B3 strain A103/KM/09 isolated in Yunnan province, 2009 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the genetic characterization of the complete genome from a human coxsackievirus B3 strain A103/KM/09 isolated in Yunnan province, 2009.</p><p><b>METHODS</b>By using RT-PCR, all the eight fragments which containing about 1000 nucleotides and covering full viral genome, were sequenced. By using Mega 5.05,Geneious, RDP 3 and SimPlot 3.5.1 software, sequences were aligned with other enterovirus reference sequences. Phylogenetic and recombination analysis were also carried out.</p><p><b>RESULTS</b>The A103/KM/09 isolate genome showed 7389 nucleotides in length , encoding for 2185 amino acids. In the complete genome, the homology of nucleotide and amino acid among the seven coxsackievirus B3 isolates were 81.0%-88.0% and 95.7%-98.0%, respectively. There appeared 81.0% and 95.7% homology when compared with that of Nancy prototype strain. Results from the Phylogenetic analysis showed that the coxsackievirus B3 formed five distinct clades, I-V. Nucleotide divergence rates between clades were 16.2%-24.3% . The A103/KM/09 strain belonged to clade V. Clade V was further divided into four sub-clades,A-D. The nucleotide divergence between sub-clades was 4.3%-11.4%. Putative recombinant event for A103/ KM/09 was detected.</p><p><b>CONCLUSION</b>All coxsackievirus B3 isolates could be divided into five clades, with A103/KM/09 strain belonged to Clade V-D. Evolution of coxsackievirus B3 had occurred in China.</p>

Complete nucleotide sequence of a human echovirus 6 strain KM57-09 isolated in Yunnan,China,in 2009 / 中华流行病学杂志

Objective To analyze the genetic characterization of the complete genome from a human echovirus 6 (Echo6) strain KM57-09 isolated in Yunnan,China,in 2009.Methods Using the RT-PCR,eight fragments containing about 1000 nucleotides which covered the whole viral genome were sequenced.The sequences were aligned with other reference cnterovirus sequences downloaded from the GenBank,using Mega 5.05,RDP 3 and SimPlot 3.5.1 softwares.Results Similar to the other human cntcrovirus,KM57-09 isolate genome appeared to have 7419 nucleotides in length,encoding for 2191 amino acids.In the complete genome,the rates of homology on nucleotide and amino acid among the seven Echo6 isolates were 79.3％-80.2％ and 93.3％ 94.4％,respectively as well as 79.3％ and 93.6％ of the rates of homology when compared with that of D' Amor prototype strain.In different segment of genome.The 2C 3A genome region was most similar to the HN-2-E25 strain,the 5' UTR,VP4,3D and 3' UTR genomc region were most similar to the CoxB5-Henan2010.In the VP1 gene,the rates of homology on nuclcotide and amino acid among the China isolates were 80.0％-96.0％ and 95.8％-99.0％,respectively,and showed 77.6％-96.0％ and 95.2％-99.0％ of the rates on homology when compared to the other Echo6 reference strains isolated from other countries or areas,respectively.Results from phylogenetic analysis showed that the Echo6 formed five distinct groups,A-E.The KM57-09 strain belonged to clade E.The nucleotide divergence between clades was 15.6％-23.3％.The putative recombinant event for KM57-09 was detected with RDP 3,SimPlot 3.5.1 and 3D sequence phylogenetic analysis.Conclusion All the Echo6 isolates could be divided into five clades,the KM57-09 strain belonged to Clade E.The Echo6 strains isolated in China were contributed to several different chains of transmission.

Preoperative Doppler evaluation of vascular perforators in the anterolateral thigh flap harvest / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the accuracy of Hadeco ES-1000spm hand-held doppler during the anterolateral thigh (ALT) flap harvest.</p><p><b>METHODS</b>Twenty-five patients (26 sides) with ALT flaps for head and neck reconstruction between May 2005 and May 2010 received preoperative Doppler examination for the location of the cutaneous perforators of ALT flaps. The Doppler signals and body mass index (BMI) were recorded preoperatively according to ABC system. The locations of Doppler signals and of the actual cutaneous perforators at surgery were plotted and compared. The diameter of perforators was measured.</p><p><b>RESULTS</b>One to three cutaneous perforators of the ALT flap were consistently found at specific locations. They were named perforators A, B, C from proximal to distal. Perforators A, B and C were present in 15 (58%), 24 (92%) and 20 (77%) cases and the diameter (> 0.5 mm) of A, B and C were 11/15, 22 (92%) and 8 (40%) respectively. The Doppler signal was within 0.5 cm of the actual perforator location in 85% flaps. The accuracy of Doppler decreased with increase of BMI.</p><p><b>CONCLUSIONS</b>Preoperative assessment by hand-held Doppler is useful in predicting the perforator vessels' locations and diameter although it's accuracy is limited.</p>

Prognostic factors and staging systems of multiple myeloma: / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies found a range of prognostic factors but no consensus about the proper staging system for multiple myeloma has been achieved. This study explored the prognostic factors to find a staging system for multiple myeloma most suitable for Chinese patients.</p><p><b>METHODS</b>Between February 1990 to August 2004, 206 patients (138 men and 68 women, mean aged (59 +/- 11) years) who were initially diagnosed as multiple myeloma in Changzheng Hospital (Shanghai, China) and had followup records were enrolled in this study. Potential prognostic factors were evaluated by univariate and multivariate analyses. Four staging systems were applied to compare their suitability for the patients.</p><p><b>RESULTS</b>The median survival time of the patients was 33 months. The 1-, 3- and 5-year survival rates were 80.18%, 48.08% and 33.7% respectively. Factors identified as adversely affecting survival were older age, severe bone lesions, low haemoglobin, low platelet, low serum calcium, low serum albumin, high proportion of plasma cells in marrow, high serum creatinine, high serum beta(2) microglobulin and high C-reactive protein. Among these, only C-reactive protein, beta(2) microglobulin, albumin and age were the independent prognostic factors. There were statistically significant survival differences among the three groups in Durie Salmon staging system and Bataille staging system, but not in British Medical Research Council staging system or International Staging System.</p><p><b>CONCLUSIONS</b>High beta(2) microglobulin, high C-reactive protein, low albumin and old age are independent prognostic factors of multiple myeloma. Bataille staging system appears to be optimal for Chinese multiple myeloma patients.</p>

Cervical lymph node metastasis of hypopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristic of cervical lymph node metastasis of hypopharyngeal carcinoma and its influence to the prognosis.</p><p><b>METHODS</b>One hundred and eight hypopharyngeal carcinoma patients who accepted treatments in the 1st Affiliated Hospital of China Medical University from 1985 to 2000 were reviewed retrospectively. All of them accepted surgical treatment without pre-operative chemotherapy or radiotherapy. Stage was made according to the standard of International Union Against Cancer (UICC) in 1992. Specimens of the patients were carefully examined to confirm the primary site of the tumor and the distribution of cervical lymph node metastasis. Pathological differentiations of the tumor were classified into high, middle and low category. Kaplan-Meier method was used to estimate the 3rd, 5th years survival.</p><p><b>RESULTS</b>The rates of lymph node metastasis of was 45.8% for patients with TI and T2 disease, 79.8% for those with T3 and T4, and 75.0% (81/108)for the whole patients(P < 0.05). Patients with pyriform sinus cancer occupied 92.6% (100/108) of all the cases. Cervical lymph node metastasis rate of pyriform sinus cancer and posterior pharyngeal wall cancer were 74. 0% and 87. 5% respectively (P > 0.05). Cervical lymph node metastasis rate of patients with the high, middle and low differentiation tumor were 72. 2% , 67.6% and 85.7% respectively (P > 0.05). The 3rd and 5th years survival rates of all patients were 67.53% and 29.87% respectively. The occurrence of cervical lymph node metastasis was 76.5% in the level II and III, and 8.6% in the level V and VI. CONCLUSIONS Cervical lymph node metastasis rate of hypopharyngeal carcinoma is high. Cervical lymph node metastasis was one of the most significant prognostic factors of hypopharyngeal carcinoma. With the increase of the cervical node metastasis, the 3rd and 5th years survival of the patients declined gradually.</p>