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Objective To investigate the effect of expanded deltopectoral perforator flap as a free skin flap for distant transfer to aesthetically repair large facial scars via microsurgical technique.Methods 20 cases of large facial scars were treated with free expanded deltopectoral skin flaps via microsurgical technique.At the first stage,24 large volume expanders were inserted into the subcutaneous pockets in the deltopectoral zone.4 to 6 months later,the second stage operation was performed when the flaps were expanded fully and facial scars removed;deltopectoral perforator flaps harvested choosing the second or the third thoracic artery perforating branches as the pedicle;the surface of the wound was covered with the flaps.Results All of the 24 flaps survived completely and the wounds healed well after transplantation.The 6 months to 2 years' follow-up results showed that the color and texture of the flaps matched the recipient place well without swelling.The superficial and deep sensation recovered very fast.Conclusions It is safe,practical and effective that the delto-pectoral perforator flaps are used to repair large facial scars avoiding the shortcomings of traditional pedicle transfer such as more procedures,longer fixed time,or more wasted expanded skin.Free transfer of expanded delto-pectoral perforator flaps can achieve ideal function and aesthetic effects.
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Objective To research the acute adverse effects of air pollution on the risk of stroke in the air pollution exposed people.Methods Daily counts of strokes occurrence (2004-2007) were obtained from the population-based stroke registry in one district of Shanghai.Air pollution data was obtained from the Shanghai Environmental Monitoring Center.A semi-parametric generalized additive model was used to study the acute effects of air pollution on stroke occurrence after controlling for long-term and seasonal trends,weather variables,and day of the week.Results The relative risks of stroke occurrence for per 10 ?g/m3 increase of PM10,SO2 and NO2 were 1.02 (95%CI:1.01-1.03),1.05 (95%CI:1.04-1.06) and 1.09 (95%CI:1.08-1.10),respectively.Conclusion The study has provided a new evidence for the association between air pollution and risk of stroke occurrence.
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OBJECTIVE To investigate in vitro activities of 12 antimicrobial agents including cefmetazole against extended-spectrum beta-lactamases-producing Escherichia coli(528 strains),Klebsiella pneumoniae(311 strains) and Proteus mirabilis(15 strains).METHODS They all collected from 15 teaching hospitals in China during 2005 and 2006 and included in the study.The levels of minimal inhibitory concentration(MIC) of 12 antimicrobial agents were determined by agar dilution method.WHONET 5.4 Software was used to analyze the data.RESULTS Against ESBLs-producing E.coli and ESBLs-producing K.pneumoniae,carbapenems were the most active antimicrobial agents(all 100.0% susceptible),followed by cephamycins(80.1-97.3%).Piperacillin/tazobactam(78.5-95.1%)showed a higher activity than cefoperazone/sulbactam(44.1-56.2%).The susceptible rate to ceftazidime against ESBLs-producing E.coli was remarkably higher than the other three cephalosporins,however the differences did not happen to ESBL-producing K.pneumoniae obviously.The susceptible rate to cefuroxime was below 1.6%.ESBLs-producing K.pneumoniae showed high sensitivity to carbapenems,cephamycins and ?-lactam/lactamase inhibitor combinations(all 100% susceptible),however the susceptible rates to cephalosporins were relatively lower.CONCLUSIONS Carbapenems and cephamycins remain the relatively high activity against ESBLs-producing Enterobacteriaceae.
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To investigate the changes of local RAS in kidney of aged rats and the regulative effect of AT1 RA, sixteen-month-old male Wistar rats were treated with the valsartan (25mg/kg) until sacrificed at the age of 24 months, and their results were compared with young and aged controls. Renin, angiotensinⅡ levels and the expressions of ATlaR mRNA, AT1bR mRNA and AT2R mRNA were measured. The results showed that plasma renin and angiotensin Ⅱ levels decreased with aging, whereas angiotensin Ⅱ in kidney cortex increased. Valsartan increased the angiotensin Ⅱ level of the aged kidney significantly . AT1aR mRNA and AT1bR mRNA were down-regulated in aged rats compared with the young group. The expression of AT2R mRNA was up-regulated with aging. Valsartan increased AT1aR mRNA, but did not modify AT1b R mRNA and AT2 R mRNA. This results indicated that angiotensin Ⅱ receptors were regulated differently with aging. Our conclusion is that in rat kidney valsartan increases renal angiotensinⅡlevel, blocks AT1R, but has no effect on gene expression of AT2R, which might enhance the protective effect by the stimulation of AT2R.
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AIM: To investigate the effects of aging on the angiotensinⅡ receptors (ATR) in different parts of the kidney. METHODS: Expression of AT 1 receptor in renal cortex was determined by Western and Northern blotting. Five micrometer thick cryostat sections of 3 or 24-month Wistar rats were mounted onto a 1.35?m thin polyethylene membrane. Glomeruli, tubules and arteries of rat kidney were isolated by laser microdissection and pressure catapulting system, AT 1aR mRNA, AT 1bR mRNA AT 2R mRNA were measured with reverse-transcription PCR(RT-PCR). RESULTS: Western and Northern blotting showed that protein and gene expression of AT 1 receptor in kidney cortex decreased in 24 month Wistar rats compared to those in 3 month Wistar rats. Glomeruli, tubules and arteries were quickly isolated by laser microdissection and pressure catapulting system without contamination. Compared to young group, AT 1aR mRNA expression was decreased in the tubules of aged rats, no changes was found in isolated glomeruli. AT 1bR mRNA was decreased in glomeruli and tubules. Both AT 1aR mRNA, AT 1bR mRNA were increased in the arteries. AT 2R mRNA was only increased in the tubules, whereas there were no significant changes in the glomeruli or arteries. CONCLUSION: Angiotensin Ⅱ receptors are regulated selectively in different portions of aged kidney, which might play an important role in aging related changes of the kidney.