Application of lobed anterolateral thigh chimeric perforator flap in repairing the complex soft tissue defects of limbs / 中华显微外科杂志

Objective:To investigate the application and surgical effect of lobed anterolateral femoral chimeric perforator flap in repairing the complex soft tissue defects of limbs.Methods:Clinical materials of 52 cases with complex soft tissue defects of limbs were retrospectively reviewed from October 2013 to October 2020. Thirty-two males and 20 females were reviewed, and the age of them ranged from 6 to 65(mean 39) years old. The injuries include 17 cases of traffic accidents, 15 machine crush injuries, 12 engineering accidents, and 8 extensive resection of malignant tumors. The size of soft tissue defects ranged from 26.0 cm×10.0 cm to 35.0 cm×15.0 cm. Lobed anterolateral thigh chimeric perforator flaps or lobed Flow-through chimeric perforator flaps were designed according to the soft tissue defects and blood circulation of the distal extremities. Start from 8-month post-operation, upper limb function was assessed according to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association and Disability of arm shoulder and hand(DASH) score scale, and Fugl-Meyer score system was used to evaluate the lower limb function. Long-term follow-up was conducted through WeChat video call and outpatient clinic evaluation.Results:All flaps survived. One patient with crush injury got delayed wound healing due to deep hemaetoma after surgery, and the rest were healed at the first stage. All the cases entered followed-up, ranged from 6 to 20(mean 8) months. The appearance of the flaps was satisfactory, and the color of the flaps has no significant difference compared with the recipient area. No recurrence of tumor was reported during the follow-up period. According to the Upper Limb Function Assessment Standard of Hand Surgery Branch of Chinese Medical Association, there were 21 excellent cases and 8 good cases, and the total excellent and good rate was 100%. The DASH score of upper limbs ranges from 11.5 to 45.1(mean 25.4±13.7), and the Fugl-Meyer score of lower limbs range from 18.6 to 31.8(mean 26.2±11.2) at the last follow-up.Conclusion:The complex soft tissue defect of limbs is a common complication caused by high-energy trauma, which is difficult to repair. The lobed anterolateral thigh chimeric perforator flap through a Decompose-Combine and arrange method for reconstruction, which is flexible in flap design. A variety of tissue flaps can be obtained by anastomosing only one group of blood vessels. It is an ideal choice for repairment of complex soft tissue defects of limbs.

Fecal transplantation can alleviate tic severity in a Tourette syndrome mouse model by modulating intestinal flora and promoting serotonin secretion / 中华医学杂志(英文版)

BACKGROUND@#: Tourette syndrome (TS) is a neuropsychiatric disorder with onset in childhood that warrants effective therapies. Gut microbiota can affect central physiology and function via the microbiota-gut-brain axis. Therefore, the gut microbiota plays an important role in some mental illnesses. A small clinical trial showed that fecal microbiota transplantation (FMT) may alleviate TS symptoms in children. Herein, FMT effects and mechanisms were explored in a TS mouse model.@*METHODS@#: TS mice model (TSMO) (n = 80) were established with 3,3'-iminodipropionitrile, and 80 mice were used as controls. Mice were grouped into eight groups and were subjected to FMT with feces from children or mice with or without TS, or were given probiotics. Fecal specimens were collected 3 weeks after FMT. 16S rRNA sequencing, behavioral observation, and serum serotonin (5-HT) assay were performed. Differences between groups were analyzed using Mann-Whitney U test and Kolmogorov-Smirnov (KS) tests.@*RESULTS@#: A total of 18 discriminative microbial signatures (linear discriminant analysis score > 3) that varied significantly between TS and healthy mice (CONH) were identified. A significant increase in Turicibacteraceae and Ruminococcaceae in TSMO after FMT was observed (P  < 0.05). Compared with non-transplanted TSMO, the symptoms of those transplanted with feces from CONH were alleviated (W = 336, P = 0.046). In the probiotic and FMT experiments, the serum 5-HT levels significantly increased in TSMO that received probiotics (KS = 1.423, P = 0.035) and in those transplanted with feces from CONH (W = 336.5, P = 0.046) compared with TSMO without transplantation.@*CONCLUSIONS@#: This study suggests that FMT may ameliorate TS by promoting 5-HT secretion, and it provides new insights into the underlying mechanisms of FMT as a treatment for TS.

A multicenter investigation on the pain experience of children with lumbar puncture and the anxiety level of their families / 中国医师进修杂志

Objective:To investigate the pain level of lumbar puncture and family anxiety of hospitalized children, and analyze the influencing factors of family anxiety.Methods:A multi-center cross-sectional survey was used to enroll 190 children and their families who underwent lumbar puncture in 4 hospitals of Jiangsu Province from July 2018 to December 2019. The FLACC scale and face pain scale (WONG-BAKER scale) were adopted. The visual analogue scale (VAS) was used to investigate the pain level, and the anxiety state-trait questionnaire (STAI) was used to investigate the anxiety level.Results:The pain level scores before and after lumbar puncture were (2.86 ± 1.08) and (6.24 ± 1.59) scores respectively, and the difference was statistically significant ( t = 24.241, P<0.001). The total anxiety level of the children′s family members was (73.78 ± 4.67) scores, which was affected by factors such as the pain score, the age of the child, the number of lumbar punctures, the success rate of a lumbar puncture, the level of the hospital, the family status, and the education level of the family (adjusted R2 = 0.574, F = 29.784, P = 0.001). Conclusions:The pain in children is at a high level, and the anxiety level of their family members is also at a high level and is affected by many factors. Clinical medical staff can stratify the children and their families, and adopt targeted methods to relieve the pain of the children and the anxiety of the family members and promote the smooth development of the lumbar puncture.

Multidisciplinary team for the diagnosis and treatment of congenital band syndrome / 中华实用儿科临床杂志

Objective:To explore the significance of multidisciplinary team for the diagnosis and treatment of congenital band syndrome.Methods:Five children with congenital circular band syndrome admitted in the First Affiliated Hospital of the Chinese People′s Liberation Army Air Force Medical University from January 2017 to January 2020 were retrospectively analyzed.They were diagnosed, treated and followed up by a multidisciplinary team including the department of obstetrics and gynecology, ultrasound, and orthopedics from the fetal stage.Results:One case was found with gradually aggravated ring band that affects the blood circulation of distal limbs during fetal examination, who was promptly performed with partial band release under fetoscopy.All cases had Patterson type Ⅰ ring bands at birth, and distal limbs did not have obvious deformity.They were performed with selective annular band resection, and postoperatively followed up for an average of 10.6 (8-13) months.The annular depression of the skin disappeared, and the appearance and function recovered satisfactory.According to the monitoring of side effects scale (Moses), 4 cases were excellent, 1 case was good, and the excellent and good rate was 100%.Conclusions:The multidisciplinary team for the diagnosis and treatment of congenital band syndrome can maximize the professional advantages of physicians with diffe-rent specialties, make early diagnosis and treatment, minimize the compression of the ring band on the limbs, and avoid serious limb deformities.It is worthy of clinical application.

Correlation of Gut Microbiome Between ASD Children and Mothers and Potential Biomarkers for Risk Assessment / 基因组蛋白质组与生物信息学报·英文版

Variation of maternal gut microbiota may increase the risk of autism spectrum disorders (ASDs) in offspring. Animal studies have indicated that maternal gut microbiota is related to neurodevelopmental abnormalities in mouse offspring, while it is unclear whether there is a correlation between gut microbiota of ASD children and their mothers. We examined the relationships between gut microbiome profiles of ASD children and those of their mothers, and evaluated the clinical discriminatory power of discovered bacterial biomarkers. Gut microbiome was profiled and evaluated by 16S ribosomal RNA gene sequencing in stool samples of 59 mother-child pairs of ASD children and 30 matched mother-child pairs of healthy children. Significant differences were observed in the gut microbiome composition between ASD and healthy children in our Chinese cohort. Several unique bacterial biomarkers, such as Alcaligenaceae and Acinetobacter, were identified. Mothers of ASD children had more Proteobacteria, Alphaproteobacteria, Moraxellaceae, and Acinetobacter than mothers of healthy children. There was a clear correlation between gut microbiome profiles of children and their mothers; however, children with ASD still had unique bacterial biomarkers, such as Alcaligenaceae, Enterobacteriaceae, and Clostridium. Candidate biomarkers discovered in this study had remarkable discriminatory power. The identified patterns of mother-child gut microbiome profiles may be important for assessing risks during the early stage and planning of personalized treatment and prevention of ASD via microbiota modulation.

A comparison of the mRECIST and RECIST criteria in the efficacy assessment of systemic chemotherapy in patients with hepatocellular carcinoma / 中华肝胆外科杂志

Objective To compare the efficacy of the solid tumor evaluation criteria 1.1 (RECIST 1.1) and the revised solid tumor efficacy evaluation criteria (mRECIST) after chemotherapy in the hepatocellular carcinoma system.Methord Retrospective analysis of 34 patients with advanced hepatocellular carcinoma who underwent Folfox4 system chemotherapy from the Department of Hepatobiliary and Pancreatic Surgery of Dongfeng Hospital affiliated to Hubei Medical College from July 2017 to July 2018,including 24 males and 10 females.Spiral CT and/or MRI (four-phase) scans were performed 1 nonth,2 months,and every 2 months after treatment,and the effects were evaluated by RECIST 1.1 and mRECIST,respectively.The survival curve was drawn by Kaplan-Meier method,and log-rank test was used to compare survival curves.Result In 34 patients evaluated with the RECIST 1.1 criteria,0 patient showed complete remission (CR),6 patients partial remission (PR),20 patients stable disease (SD),and 8 patients progressive disease (PD).Using the mRECIST criteria,CR:0,PR:10,SD:17,and PD:7 patients.The Kappa value of the two methods was 0.271,95％ CI:0.010 ～0.535.The log-rank test showed that there was no significant difference in the survival curves of patients between PR,SD and PD in RECIST 1.1 (P ＞ 0.05).The cumulative survival rates were 40.0％,11.8％ and 0,respectively.The survival curves of patients with PR,SD and PD in mRECIST were statistically significant (P ＜ 0.05),and the cumulative survival rates were 37.5％,0,and 0,respectively.Conclusion The mRECIST criteria were more suitable than the RECIST 1.1 criteria in assessing efficacy of systemic chemotherapy for hepatocellular carcinoma.

Lai’s Tongyuan Acupuncture Therapy in Treatment of Depressive Neurosis / 沈阳医学院学报

Objective:To observe the effects of Lai’s Tongyuan acupuncture therapy on depressive neurosis.Methods:A total of 38 patients with depressive neurosis were randomized into the control group and treatment group. On basis of oral Fluoxetine hydrochloride, the control group was given common acupuncture method, the treatment group was given Lai’s Tongyuan acupuncture therapy. The scores of HAMD and ADR were observed after treating 4 weeks, 8 weeks and 12 weeks. Results:The scores of HAMD in 2 groups were significantly lower than before, the scores of HAMD and SDS in the treatment group was significantly lower than that in the control group (P<0.05).Conclusion:Lai’s Tongyuan acupuncture therapy has better effects for depressive neurosis patients in clinical efficacy.

Investigation and Analysis of the Medication Safety Status of Chinese Patent Medicines for Residents in 3 Cit-ies of Guangdong Province / 中国药房

OBJECTIVE:To investigate the medication safety status of Chinese patent medicines and related influence factors for residents in Guangdong province,and provide reference for better guarantee of medication safety for residents. METHODS:Questionnaires were randomly sent out among the residents in 3 cities of Guangdong province. The cognition,utilization habit and safety awareness,the ways to get the related information of Chinese patent medicines and purchase way were surveyed and ana-lyzed statistically. RESULTS:Totally 530 questionnaires were sent out and 514 valid questionnaires were collected with effective re-covery of 96.98%. There are 64.01% of respondents didn’t know the composition of Chinese patent medicines;50.39% didn’t know the contraindications of Chinese patent medicines;48.44% didn’t know the adverse drug reactions of Chinese patent medi-cines that they were using;23.47% had once broken the tablets when took them;65.18% didn’t know that the old people had less dosage than teenagers and 44.75% didn’t know that Chinese patent medicines couldn’t be taken with some western medicines. There were many ways to get the related information of Chinese patent medicines and purchase them,and the main sources were from doctors and pharmacists in drug stores;90.08% had purchased Chinese patent medicines in drug stores. CONCLUSIONS:During daily medication of Chinese patent medicines,the biggest problem for residents is that the weak awareness of medication safety,unreasonable medication behavior and habit caused by lack of related knowledge of medication safety,which may cause safety risks or happen medication safety problems. Therefore,the residents’education of self-medical knowledge should be intensi-fied,the management of prescription in drug stores should be enhanced,pharmaceutical service function of pharmacists should be played,supervision management of drug advertisement should be strengthened and the contents in drug instructions should be regu-lated.

Effect of Fucongxiang Liquid on Hippocampal Neurons in Rat Models with Vascular Dementia / 广州中医药大学学报

【Objective】 To investigate the effect of Fucongxiang Liquid (FL) on hippocampal CA1 neurons in rat models with vascular dementia. 【Methods】 Forty SD rots were randomized to four groups: pseudo-operation group, model group, Naofukang group and FL group. Rat models with vascular dementia were established by repeated cerebral ischemia/reperfusion combined with decreasing blood pressure and then were given with normal saline, Naofukang and FL respectively for 15 days. After treatment, the brain of mrs was taken out to make slices for hematoxylin and eosin staining to observe the histomorphological changes of hippocampal CA1 neurons. 【Results】 As compared with the pseudooperation group, a large amount of damaged, degenerative or even necrotic neurons were fotmd in the model group; FL and Naofukang could reduce the damage of neurons to different extents. 【Conclusion】 FL exerts a protective effect on hippocampal CA1 neurons in mice models with vascular dementia.