One-stage repair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps / 中国骨伤

OBJECTIVE@#To explore clinical effects of the stageⅠrepair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps.@*METHODS@#From January 2019 to May 2020, 21 patients(27 middle phalanx fingers)with full-thickness skin defect were repaired at stageⅠusing artificial dermis combing with digital artery perforator fascial flaps. All patients were emergency cases, and were accompanied by the exposure of bone tendon and the defects of periosteum and tendon membrane. Among patients, including 11 males and 10 females aged from 18 to 66 years old with an average age of (39.00±8.01) years old;9 index fingers, 10 middle fingers and 8 ring fingers;range of skin defect area ranged from (2.5 to 3.5) cm×(1.5 to 3.0) cm;range of exposed bone tendon area was (1.5 to 2.0) cm×(1.0 to 2.0) cm. The time from admission to hospital ranged from 1 to 6 h, operation time started from 3 to 8 h after injury.@*RESULTS@#All patients were followed up from 6 to12 months with an average of (9.66±1.05) months. The wounds in 26 cases were completely healed at 4 to 6 weeks after operation. One finger has changed into wound infection with incompletely epithelialized dermis, and achieved wound healing at 8 weeks after dressing change. All fingers were plump with less scars. The healed wound surface was similar to the color and texture of the surrounding skin. These fingers have excellent wearability and flexibility. According to the upper limb function trial evaluation standard of Hand Surgery Society of Chinese Medical Association, the total score ranged from 72 to 100. 26 fingers got excellent result and 1 good.@*CONCLUSION@#StageⅠrepair of full-thickness skin defect at dorsal skin of middle phalanx fingers using artificial dermis combing with digital artery perforator fascial flaps is easy to operate with less trauma. It has made satisfactory recovery of appearance and function of fingers. It could provide an effective surgical method for clinical treatment of full-thickness skin loss of fingers with tendon and bone exposure.

Application and analysis of endoscopic surgery in treating carpal tunnel syndrome / 中国内镜杂志

Objective To investigate the clinical effect of endoscopic treatment of carpal tunnel syndrome (CTS) with subsynovial hyperplasia. Methods 37 cases (total 41 wrists) of CTS with subsynovial hyperplasia who accepted endoscopic treatment in our hospital were retrospectively analysised, all the transverse ligament of wrist were cutted off under endoscope and the hyperplastic subsynovial membrane arounding the superficial flexor tendon of finger. The changes of clinical symptoms and signs before and after operation were compared. Results According to Kelly classification, the overall excellent and good rate was 95.12%. After operation, the feel of numb and pain during night disappeared in all patients, the positive rate of Tinel and Phalen sign was both reduced to 2.44% (P < 0.05), and the mean value of two-point discrimination was reduced to (3.5 ± 0.9) mm. No serious complication occurred during treatment. Conclusion For the patients of CTS with subsynovial hyperplasia, to cut the transverse ligament tendon under endoscope and remove the subsynovial around the flexor tendon at the same time is a new and feasible surgical procedure with notable curative effect, which deserves clinical popularization.

Correlation between the expression of JARID1B/KDM5B in breast cancer tissues and the circulating tumor cells / 基础医学与临床

Objective To investigate the relation between expression of JARID1B/KDM5B in invasive breast cancer tissue and circulating tumor cells of invasive breast patients. Methods The S-P immunohistochemical method was used to observe the expression of JARID1B/KDM5B in lesions.imFISH method was used to detect circulation tumor cells. Results Twenty-seven cases of patients showed CTC positive(the number of CTC was more than or equal to 2) in 35 invasive breast cancer cases,The results of JARID1B/KDM5B expression were as follows:(-) (n=0) and (+) in 1 case,(++) in 3 cases,(+++) in 23 cases,8 cases of negative cases (the number of CTC < 2), JARID1B/KDM5B immune group of results:(-) (n=2),(+) in 2 cases,(++) in 1 case,(+++) in 3 cases, The positive relation was found in expression of JARID1B/KDM5B and circulating tumor cells(P<0.05). Conclu-sions JARID1B/KDM5B positive expression in tumor tissues has a certain significance in predicting the recurrence and metastasis of tumor.

Association of estrogen receptor alpha gene polymorphisms with bone mineral density: a meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A number of studies have examined the association between estrogen receptor alpha (ESR-α) gene polymorphisms and bone mineral density (BMD), but previous studies of ESR-α gene XbaI (rs9340799) and PvuII (rs2234693) polymorphisms have been hampered by small sample size, regional restrictions and inconclusive results. Thus a meta-analysis is needed to assess their pooled effects.</p><p><b>METHODS</b>This study reviewed all published articles indexed in Pubmed using the keywords in the title or abstract. All data were extracted independently by two reviewers using a standard form, the studies were meta-analyzed and minor discrepancies were resolved by authors' discussion.</p><p><b>RESULTS</b>Twenty seven eligible studies involving 8467 women and 2032 men were identified. The XbaI and PvuII polymorphisms were significantly associated with BMD of the lumbar spine. XX and PP homozygotes had a protective effect in comparison with carriers of the x and p alleles, the effects were more significant in premenopausal women or Western women. At the femoral neck, the results were different. XX served as a protective factor in postmenopausal women, Western women, Western postmenopausal women, and men, while PP was likely to serve as a risk factor in Eastern women, Eastern postmenopausal women, and men.</p><p><b>CONCLUSIONS</b>The XbaI polymorphism is correlated to BMD at diverse skeletal sites. PP had a protective role for the lumbar spine but might be a risk factor for the femoral neck.</p>

Reconstruction of soft-tissue defects in hands using the free proximal posterior interrosseous artery forearm perforator flaps / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the applied anatomy of the proximal posterior interrosseous artery perforator flap (PIAP) and report the clinical results of repairing the soft tissue defects in hands.</p><p><b>METHODS</b>Between September 2007 and January 2011, 21 patients with 24 soft tissue defects in hands were repaired with the free proximal PIAP flap transplantation. The size of the flaps ranged from 2.0 cm x 1.5cm to 7cm x 5cm. The longest length of these flaps was 9 cm. 9 flaps were dissected with one additional superficial vein to anastomose with the superficial vein at the recipient sites.</p><p><b>RESULTS</b>19 flaps survived completely. Bubbles and violet color happened in 4 flaps which survived finally after partial suture removal. Flap necrosis occurred in one flap. The clinical results were satisfactory after 6-25 months of following-up, and the scars at the donor sites were not obvious.</p><p><b>CONCLUSIONS</b>The free PIAP flaps have constant, reliable blood supply, and good texture. It is a good option for repairing soft-tissue defects in the hands.</p>

Anatomy of the free descending genicular artery perforator flap and its clinical application for soft-tissue defects at extremities / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of free descending genicular artery perforator flaps in the soft tissue defects at extremities.</p><p><b>METHODS</b>Ten fresh cadavers were injected with lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized volume-rendering software ( Materiaise's interactive medical image control system, MIMICS). The origin, course and distribution of the perforators in the thigh and leg region were observed. 11 patients with skin defects at the distal part of extremities were treated. The flap size ranged from 5 cm x 8 cm to 6 cm x 15 cm. Six flaps were pedicled with the descending genicular artery and the others were pedicled with the perforator of the descending genicular artery. All flaps were transferred by end to end anastomosis. RESULTS The follow-up period ranged from 6 to 18 months. All the flaps survived. The appearance and texture of the flaps were good with sensory recovery of S3.</p><p><b>CONCLUSIONS</b>Free descending genicular artery perforator flap has a reliable blood supply and suitable thickness for the treatment of soft tissue defects at extremities. The technique is easily performed with reliable results.</p>

The relationship between GAPDH mRNA degradation in the mouse liver and postmortem interval / 法医学杂志

OBJECTIVE@#To explore the relationship between degradation of glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA in the mouse liver and postmortem interval (PMI).@*METHODS@#Sixty NIH mice were sacrificed by cervical dislocation and suffocation, and then placed into 10 degrees C and 25 degrees C temperature-controlling systems. The changes of GAPDH mRNA in the liver were detected by two-step fluorimetric reverse transcriptase polymerase chain reaction (RT-PCR) technique and nucleic acids protein cryoscope from 0 to 48 h postmortem.@*RESULTS@#In the mouse liver, the amplification products of GAPDH mRNA could be examined within 48 h postmortem in 10 degrees C temperature-controlling system and within 36 h postmortem in 25 degrees C temperature-controlling system. The amplification products showed a decreasing tendency.@*CONCLUSION@#Degradation of GAPDH mRNA in the mouse liver is negative correlation with PMI. GAPDH mRNA could be a new marker for estimation of PMI.