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.

Challenges in Using the Posterior Inferior Cerebellar Artery for Revascularization of the Anterior Inferior Cerebellar Artery: A Microsurgical Anatomic Study.

BACKGROUND: A bypass is usually required to prevent ischemia during the treatment of anterior inferior cerebellar artery (AICA) aneurysms. The intracranial (IC)-to-IC bypass provides several advantages over the extracranial-to-IC bypass in the posterior fossa. However, there are only 2 case reports about AICA revascularization with the posterior inferior cerebellar artery (PICA). We aimed to investigate the microsurgical anatomical challenges for PICA to AICA anastomosis. METHODS: Ten cadaveric heads injected with colored silicone were inspected on both sides using a lateral transcondylar approach. After the donor and recipient arteries were examined from the posterior side, neurovascular contents of the posterior fossa were excised and the origin, course, and variations of both arteries were investigated from the anterior view. The diameters of the AICA and PICA segments and the intersegment distance were measured. RESULTS: PICA variations and posteromedial origins from the vertebral artery were identified in 8 of the 20 right and 6 of the 20 left sides, and the first segment of the PICA was not present in 7 sides. Furthermore, in 18 sides, the PICA was trapped between the lower cranial nerves and dentate ligaments. Therefore the donor artery could not be brought closer than 1 cm to the recipient artery in 19 sides. Moreover, AICA variations were identified in 6 sides, and in 12 sides, the diameter of the recipient artery was <1 mm. CONCLUSIONS: The mostly PICA-related issues made PICA-to-AICA anastomosis unfeasible in all cadaveric heads included in the study.

Wrist arthroscopy-assisted ulnar head Wafer resection versus ulnar shortening osteotomy for treatment of ulnar impaction syndrome / 中华创伤骨科杂志

Objective:To compare the clinical efficacy between wrist arthroscopy-assisted ulnar head Wafer resection and ulnar shortening osteotomy in the treatment of ulnar impaction syndrome.Methods:From March 2012 to February 2017, 45 patients with ulnar impaction syndrome were treated at Department of Hand Surgery, No. 6 Hospital of Ningbo. They were 26 males and 19 females, aged from 28 to 48 years (average, 38 years). The right side was affected in 31 cases and the left side in 14. They were divided into 2 groups according to different surgical methods: 22 patients were subjected to arthroscopy-assisted ulnar head Wafer resection (the resection group) and 23 to open ulnar shortening osteotomy and internal fixation (the osteotomy group). Preoperative X-rays were taken to evaluate the height of positive ulnar variances and MRI was used to initially assess the damages to triangular fibrocartilage disc complex (TFCC), the semilunare and the tri-quetrum. Arthroscopy was conducted to evaluate intra-articular conditions, remove hyperplastic synovial membrane and repair the injured TFCC. In the resection group, the patients underwent arthroscopic ulnar head Wafer resection while in the osteotomy group, the patients underwent open ulnar shortening osteotomy and plate fixation. The platelet-rich plasma (PRP) was injected into the wrist joint in all cases after operation. Regular follow-ups and X-rays were performed to observe healing of the ulna. The wrist function was evaluated by the modified Mayo scoring system.Results:There was no significant difference in the general data between the resection group and the osteotomy group, showing comparability beween groups( P>0.05). Twenty patients in the resection group were followed up for an average time of 13.7 months. Their modified Mayo scores were 80.3±6.2; 7 of them were rated as excellent, 11 as good and 2 as fair, yielding a good and excellent rate of 90.0%(18/20). Twenty-two patients in the osteotomy group were followed up for an average time of 14.3 months. Three of them reported slight pain at 6-month follow-up. Their modified Mayo scores were 85.1±5.9; 6 of them were rated as excellent, 13 as good and 3 as fair, yielding a good and excellent rate of 86.4%(19/22). There was a significant difference in the modified Mayo scores between the 2 groups ( P<0.05). Conclusion:In treatment of ulnar impaction syndrome with the height of positive ulnar variances ≤3 mm, wrist arthroscopy-assisted ulnar head Wafer resection can obtain better clinical results than ulnar shortening osteotomy.

Study on correlation of thyroid hormone level, lipid and glucose metabolism and blood uric acid in patients with hyperthyroidism / 国际检验医学杂志

Objective To explore the correlation of thyroid hormone level, blood glucose level, blood lipid level and blood uric acid in patients with hyperthyroidism.Methods Totally 87patients with hyperthyroidism who were treated in our hospital from June 2015to December 2017were selected as the observation group, the other 69healthy people in the same period were selected as the control group.The fasting blood glucose (FBG), total cholesterol (TC), three glycerol (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), free three triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) and blood uric acid level were compared, and the correlation among the above indicators were analyzed.Results The levels of FBG, FT3, FT4and blood uric acid before treatment in the observation group were higher than those of the control group, and the levels of TSH, TC, TG, HDL-C and LDL-C were lower than those of the control group, the differences were statistically significant (P＜0.05).After treatment, the levels of FBG, FT3, FT4and blood uric acid were significantly decreased in the observation group, while the levels of TSH, TC, TG, HDL-C and LDL-C increased significantly, the differences were statistically significant between before and after treatment (P＜0.05).The levels of FT3and FT4were positively correlated with blood uric acid and FBG level in hyperthyroidism patients, and negatively correlated with the levels of TC, TG, HDL-C and LDL-C.The level of TSH was positively correlated with the levels of TC, TG, HDL-C and LDL-C, and had a negative correlation with the levels of FBG and blood uric acid.Conclusion The thyroid hormone level is closely related to lipid and glucose metabolism and blood uric acid level in hyperthyroidism patients.When the thyroid hormone is corrected, the blood glucose and blood lipid indexes turn to normal.It suggests that the clinical treatment of hyperthyroidism should be taken as the main means to correct the abnormal thyroid hormone.

Progress in the treatment of scaphoid nonunion / 中华创伤杂志

There is a high probability of scaphoid nonunion after scaphoid fracture, which can lead to wrist arthritis and further to progressive aggravation of joint function, seriously affecting daily life and work. Currently, there are a variety of treatment methods for scaphoid bone nonunion at home and abroad, and surgical treatment is the major option, which includes open surgery and arthroscopy assisted minimally invasive surgery. Different operative methods have corresponding indications and contraindications with different therapeutic effects. Arthroscopic assisted technique is novel, minimally invasive, and reliable. This article reviews the treatment methods of scaphoid nonunion, including screw internal fixation, non vascularized bone graft, vascularized bone graft, anastomotic vascularized bone graft, bone block resection, arthrodesis, and arthroscopic minimally invasive surgery, so as to provide references for clinical treatment of scaphoid nonunion.

Effect of 60Co-γ Ray Irradiation on the Four Components in Tongmai Granules / 中国药师

Objective: To study the effect of 60Co-γ ray irradiation on the contents of danshensu,protocatechuic aldehyde,puerarin and salviamolic acid B in Tongmai granules by HPLC. Methods: An Agilent ZORBAX Eclipse XDB C18(2) column (250 mm × 4. 6 mm,5 μm) was adopted and the wavelength of UV detection was 280 nm at the flow rate of 1. 0 ml·min-1. The mobile phase consisted of 0. 1% phosphoric acid (B) and acetonitrile (A) with gradient elution, and the column temperature was 35℃. Tongmai granules were irradiated by 60Co-γ ray respectively at 0, 2, 5,10 and kGy,the contents of the active ingredients were compared before and after the irradiation. Results: The linear range of danshensu,protocatechuic aldehyde,puerarin and salviamolic acid B was 0. 098-4. 925 μg, 0. 028-1. 411 μg, 0. 378-18. 882 μg and 0. 218-10. 888 μg, respectively. The average recovery was 99. 8% , 97. 7% , 99. 9% and 99. 9% , respectively. When the radiation dose was not more than 2 kGy, the contents of the five components did not change significantly (P>0. 05). After 5 kGy radiation, the contents of protocatechuic aldehyde and salviamolic acid B were signifi-cantly different (P <0. 05). Conclusion: The dose of 60Co ray should be controlled not more than 2 kGy, and the sterilization method is safe and effective for Tongmai granules.

Epidemiological survey of asthma among children aged 0-14 years in 2010 in urban Zhongshan, China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence, current treatment, and clinical characteristics of asthma, as well as the risk factors for this disease, among children aged 0-14 years in 2010 in urban Zhongshan, China.</p><p><b>METHODS</b>A total of 10 336 children aged 0-14 years were selected from urban Zhongshan by cluster random sampling. The Third National Childhood Asthma Epidemiological Questionnaire 2010 was used to analyze the prevalence, current treatment, and clinical characteristics of childhood asthma, as well as the risk factors for this disease.</p><p><b>RESULTS</b>Asthma was diagnosed in 179 cases (1.73%). The prevalence of asthma in male children was significantly higher than that in female children (2.25% vs 1.16%; P<0.01). Of the 179 patients, severe attacks were common in 104 cases (58.1%), 110 cases (61.5%) had slow onset, 102 cases (57.0%) had gradually relieved conditions, 61 cases (34.1%) suffered from asthma during seasonal transition, and 150 cases (83.8%) developed asthma due to respiratory tract infection. Among all asthmatic children, 71.5% had been treated with inhaled corticosteroids, and 71.5% had been treated with bronchodilator. The multivariate logistic regression analysis showed that a history of penicillin allergy, a family history of allergy, food allergy, eczema, allergic rhinitis, cesarean delivery, family mould, and perinatal passive smoking were independent risk factors for childhood asthma.</p><p><b>CONCLUSIONS</b>The prevalence of childhood asthma in urban Zhongshan is on a high level, and is associated with gender. The treatment of asthma has been standardized, but still needs further improvement. The onset of asthma attack is influenced by various factors.</p>

Does the calcification of adamantinomatous craniopharyngioma resemble the calcium deposition of osteogenesis/odontogenesis?

AIMS: Calcification in adamantinomatous craniopharyngioma (ACP) is troublesome for surgical intervention. The aim of this study was to examine the osteogenic proteins that play important roles in the calcium deposition of the odontogenic/osteogenic tissues in craniopharyngioma. METHODS AND RESULTS: Craniopharyngiomas (n = 89) were investigated for the presence and expression pattern of the osteoinductive/odontoinductive factor bone morphogenetic protein-2 (Bmp2) and two osteoblastic differentiation makers, Runt-related transcription factor-2 (Runx2) and Osterix, using immunohistochemistry and Western blotting. Our results showed that Bmp2, Runx2 and Osterix levels increased in cases with high calcification and correlated positively with the degree of calcification in ACP, whereas they showed little or no expression in squamous papillary craniopharyngioma. In ACP, Bmp2 was expressed primarily in the stellate reticulum and whorl-like array cells; Runx2 and Osterix tended to be expressed in calcification-related epithelia, including whorl-like array cells and epithelia in/around wet keratin and calcification lesions. CONCLUSIONS: Our study indicated, for the first time, that osteogenic factor Bmp2 may play an important role in the calcification of ACP via autocrine or paracrine mechanisms. Given the presence of osteogenic markers (Runx2 and Osterix), craniopharyngioma cells could differentiate into an osteoblast-like lineage, and the process of craniopharyngioma calcification resembles that which occurs in osteogenesis/odontogenesis.

Incidence of wheezing and chronic cough in children aged 3-14 years in rural and urban areas of Zhongshan, China: a questionnaire survey / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence of wheezing and chronic cough in children aged 3-14 years in different living areas of Zhongshan, China.</p><p><b>METHODS</b>According to the unified program of the 2010 national epidemiological survey of asthmatic children aged 0-14 years, a questionnaire survey of the children aged 3-14 years in rural and urban areas of Zhongshan was conducted.</p><p><b>RESULTS</b>A total of 15 763 children were included in the survey. Among all participants, 8 248 were from the urban area, and 7 515 from the rual area; 8 306 were boys, and 7 457 were girls. The percentage of children with a history of wheezing was significantly higher in the urban group than in the rural group (6.6% vs 3.2%; P<0.05), and it was significantly higher in boys than in girls for each group (P<0.05). The urban group had a significantly higher percentage of individuals who had wheezing in the past one year than the rural group (2.8% vs 1.5%; P<0.05), and this percentage was significantly higher in boys than in girls for each group (P<0.05). Compared with the rural group, the urban group had a significantly higher percentage of individuals who had chronic cough (duration 1 year) (7.9% vs 3.1%; P<0.05). The above indices were relatively high in children under 6 years of age, and all but the percentage of girls who had wheezing in the past one year in both rural and urban areas showed significant differences between all age groups.</p><p><b>CONCLUSIONS</b>The incidence of wheezing and chronic cough varies with age, sex, and living area for children aged 3-14 years in Zhongshan, and it is relatively high under 6 years of age, in the urban area, and among boys.</p>

Hemolymphangioma of the chest wall: A rare case report.

Hemolymphangioma is a rare, benign and non-invasive type of tumor. Only a few cases have been reported in the literature. In the present study, we report a case of hemolymphangioma growing on the left anterior chest wall of a 57-year-old woman. Physical and laboratory examinations were all normal. However, computed tomography (CT) revealed a mass. A CT-guided biopsy was performed, followed by a thoracoscopic resection and thoracotomy. The postoperative course of the patient was uneventful. Follow up of the patient is ongoing. The findings of this case report, however, showed the significance of complete excision versus minimally invasive surgery to reduce recurrence.

HPLC determination of the contents chlorogenic acid and hydrochlorothiazide in zhenjujiangyapian / 中国中药杂志

<p><b>OBJECTIVE</b>To establish an HPLC method for determination of chlorogenic acid and hydrochlorothiazide in Zhenjujiangyapian.</p><p><b>METHOD</b>The HPLC method was carried on C18 column using methanol-0.1% phosphoric acid(20: 80) as mobile phase, and the detection wavelength was 327 nm, the flow rate was 1.0 mL x min(-1) and the temperature of column was 40 degrees C.</p><p><b>RESULT</b>In the HPLC method, the calibration curve for chlorogenic acid, hydrochlorothiazide were linear in the range of 0.049 6-0.496 (r = 0.999 5) and 1.002-10.02 microg (r = 0.999 8). The average recovery for chlorogenic acid, hydrochlorothiazide were 101.0% and 100. 1%. RSD were 2.0% and 1.4% (n = 9), respectively.</p><p><b>CONCLUSION</b>The method is convenient, precise and reliable for determining the content of chlorogenic acid and hydrochlorothiazide in Zhenjujiangyapian.</p>

Inhibitory effect of ZD6474 combined with adriamycin on MCF-7 human breast cancer cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the killing effect of ZD6474 combined with adriamycin (ADM) on MCF-7 human breast cancer cells.</p><p><b>METHODS</b>The inhibitory effects of ZD6474 and ADM alone and in combination on the proliferation of MCF-7 cells were assessed by MTT assay. The cell cycle and cell apoptosis were detected by flow cytometry.</p><p><b>RESULTS</b>ZD6474 and ADM both significantly inhibited the proliferation of MCF-7 cells, showing a synergistic effect of their reactions in combined use (P<0.05). ZD6474 or ADM alone caused cell cycle arrest at G0/G1 and S phases, respectively. Combined use of the two drugs resulted in significant reduction of the M-phase cell percentage and cell cycle arrest at G0/G1 and S phases. The coadministration of the drugs significantly increased the apoptosis rate of the cells as compared with ZD6474 or ADM treatment alone (P<0.05).</p><p><b>CONCLUSIONS</b>ZD6474 and ADM show a synergistic effect in inhibiting the proliferation and inducing apoptosis of MCF-7 cells.</p>

Correlation between polymorphism of apolipoprotein E gone and electroencephalogram after mild/moderate traumatic brain injury / 中华创伤杂志

Objective To determine the relationship between polymorphism of apolipoprotein E gene (APOE) and electroencephlogram in patients with mild/moderate traumatic brain injury. Methods (1) Venous blood for 2 ml was collected from 81 patients with mild/moderate traumatic brain injury on admission. APOE genotype was identified by PCR restriction fragment length polymorphism ( PCRRFLP). (2) All the patients were monitored by electroencephalogram for 2-3 times within a week after injury. X2 test and logistic regression analysis via SAS version 8.2 were performed to analyze the results of genotype and electroencephalogram and clinical data. Results The distributions of genetypes and alleles among 81 patients matched with Haldy-Weinberg Law. The findings of electroencephalogram were significantly different between patients with and without APOEε4 (P<0.05). Ten (63%) out of 16 patients with APOEε4 showed an aggravated electroencephalogram,while only 16 (25%) out of 65 patients without APOEε4 showed the same results of electroencephalogram. Logistic regression analyses showed that APOEε4 was a risk factor for electroencephalogram aggravation after traumatic brain injury. Conclusion APOEε4 is a risk factor for electroencephalogram aggravation during acute stage after mild/moderate traumatic brain injury.

The change of plasma endothelin and atrial natriuretic peptide in heart failure infants and the effect of applying milrinone / 中国医师进修杂志

Objective To determine the change and effect of milrinone on the concentration of plasma endothelin(ET)and atrial natriuretic peptide(ANP)in congestive heare failure(CHF)infants.Methods Forty-one CHF infants' plasma ET and ANP concentration were determined before and after having received milrinone intravenously,meanwhile compared with that of 40 healthy infants as control.Results The concentration of plasma ET and ANP in CHF infants were obviously increased,which has greatly decreased after intravenous dripping of milrinone.The difference has statistic significance.Conclusion The concentration of plasma ET and ANP in CHF infants are greatly increased and could be lowered by treating with milrinone.

The application of structural equation model approach in epidemiological research / 中华流行病学杂志

<p><b>OBJECTIVE</b>To discuss application of structural equation model (SEM) approach in epidemiological research.</p><p><b>METHODS</b>A brief overview on major components of SEM, statistical assumptions underlying the use of SEM, and current software available to users and how SEM can be used were discussed through a practical epidemiological research project.</p><p><b>RESULTS</b>Advantages of SEM comparing with conventional epidemiological approach were shown. SEM, having the nature of comprehensive thinking and analytic approach, not only exploring the association between factors and diseases but also among factors. It also served a confirmatory, rather than exploratory approach on data modeling, as well as having the capability of correcting estimates by separating measurement error from the equations, to provide modeling the latent variables.</p><p><b>CONCLUSION</b>SEM approach could be used in epidemiological research as having some advantages comparing with conventional epidemiological approaches.</p>

The clinical observation of oxaliplatin combined with capecitabin for patients with advanced colorectal cancer / 肿瘤研究与临床

Objective To observe the therapeutic effect and toxicity reaction of Oxaliplatin com- bined with XeLoda in the treatment of 42 patients with advanced colorectal cancer.Methods All the pa- tients were treated with Oxaliplatin(130 mg/m~2,ivgtt for 2 h,d1)combined with XeLoda(2000 mg?m~(-2)?d~(-1), po,bid,d1 to d14).The regime was repeated every 21 days for at least 3 consecutive cycles.Results The to- tal response rate was 40.5%(17/42)in which 2 got CR and 15 PR.24 patients got Kamofsky score increased. The major toxic effects were alopecia,peripheral neuritis,gastrointestinal tract reactions and myelosuppression. Conclusion Oxaliplatin combined with XeLoda regimen is effective in the treatment of advanced colorectal cancer,and its toxicity is tolerable.It is worth studying in the future.